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Therapeutic Resistance in G-CSF Producing Lung Cancer With EGFR Mutation
Koki Ito1, Kyoichi Kaira1, Hisao Imai1
1Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan.
Background/Aim:
Granulocyte colony-stimulating factor (G-CSF)-producing neoplasms are relatively rare; however, little is known on the clinical features of G-CSF-producing lung cancer harboring activating epidermal growth factor receptor (EGFR) mutations.
Case Report:
A 66-year-old female was definitively diagnosed with G-CSF-producing lung cancer that was positive for EGFR mutations. She repeatedly received epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), such as osimertinib and afatinib. However, she developed resistance to these molecular-targeting drugs within 2 to 3 months after immediate shrinkage. Thus, the patient was treated with chemoimmunotherapy including bevacizumab, and demonstrated a slight survival benefit.
Conclusion:
Overall, G-CSF-producing lung cancers positive for EGFR mutations were resistant to different treatment modalities. Clinicians should be attentive to the potential resistance of G-CSF-producing EGFR mutant lung cancer to EGFR-TKI therapy.
Insights
Granulocyte colony-stimulating factor (G-CSF)-producing lung cancers with EGFR mutations show resistance to targeted therapies. Further research is needed to understand and overcome treatment challenges in these rare neoplasms.
Area of Science:
- Oncology
- Molecular Biology
Background:
- Granulocyte colony-stimulating factor (G-CSF)-producing neoplasms are rare.
- Clinical features of G-CSF-producing lung cancer with activating EGFR mutations are not well understood.
Purpose of the Study:
- To describe the clinical features and treatment response of a patient with G-CSF-producing lung cancer harboring EGFR mutations.
Main Methods:
- Case report of a 66-year-old female with G-CSF-producing lung cancer and EGFR mutations.
- Treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and subsequent chemoimmunotherapy.
Main Results:
- The patient developed rapid resistance to EGFR-TKIs (osimertinib, afatinib) within 2-3 months.
- Chemoimmunotherapy including bevacizumab provided a slight survival benefit.
Conclusions:
- G-CSF-producing lung cancers with EGFR mutations exhibit resistance to various treatment modalities.
- Clinicians must be aware of the potential resistance to EGFR-TKI therapy in these specific lung cancer cases.
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