Osimertinib and palbociclib in an EGFR-mutated NSCLC with primary CDK4 amplification after progression under...

Area of Science:

• Oncology
• Molecular Biology
• Pharmacology

Background:

• Precision medicine revolutionizes non-small cell lung cancer (NSCLC) treatment for patients with specific molecular alterations.
• Acquired or primary resistance to targeted therapies remains a significant clinical challenge in NSCLC management.

Purpose of the Study:

• To report a case of successful combined treatment in a metastatic NSCLC patient with EGFR exon 19 deletion, PIK3CA mutation, and CDK4 amplification.
• To evaluate the efficacy of combining osimertinib with palbociclib in a patient who developed resistance to osimertinib monotherapy.

Main Methods:

• Case report of a 61-year-old male with metastatic NSCLC.
• Initial treatment with osimertinib (EGFR TKI), followed by progression.
• Subsequent treatment with combination osimertinib and palbociclib (CDK4/6 inhibitor).

Main Results:

• The patient achieved an initial partial response to osimertinib monotherapy.
• Disease progression occurred after 4 months of osimertinib.
• Combination therapy with osimertinib and palbociclib resulted in an ongoing partial response for over 10 months with clinical improvement, despite transient pneumonitis.

Conclusions:

• Combined osimertinib and palbociclib therapy demonstrates efficacy in a NSCLC patient with EGFR mutation, PIK3CA mutation, and CDK4 amplification, overcoming resistance.
• CDK4 amplification occurs in approximately 10% of treatment-naïve EGFR-mutated NSCLC patients, suggesting this combination therapy could benefit a relevant patient subgroup.