Successful treatment of a patient with NSCLC carrying uncommon compound L861Q/G719X epidermal growth factor receptor
Zihan Zhou1,2, Jie Huang1, Ming Ding1
1Department of Respiratory and Critical Care Medicine, Southeast University Zhongda Hospital, Nanjing, Jiangsu, China.
Abstract:
The availability of targeted therapies for molecular aberrations have substantially improved the outcomes of advanced non-small-cell lung cancer (NSCLC) patients harboring sensitive mutations. However, patients harboring uncommon epidermal growth factor receptor (EGFR) mutations such as G719X and L861Q often resulted in a lack of response to the first and third generation of EGFR TKIs. In this study, we reported a 64-year-old female patient, who initially presented with symptoms of pneumonia and showed positive response to anti-infection treatment, eventually diagnosed with stage Ⅳ lung adenocarcinoma (LUAD) harboring a rare EGFR G719X and L861Q compound mutations. The patient received 40 mg/day of afatinib and experienced no severe adverse events. As a result, partial response (PR) was observed based on CT scan and a progression free survival of 24 month was achieved. Her follow-up is still ongoing. The results of the present case support the effectiveness and safety of afatinib in LUAD patients carrying EGFR G719X and L861Q compound mutations.
Insights
Afatinib shows promise for advanced lung adenocarcinoma patients with rare EGFR G719X/L861Q mutations. This targeted therapy achieved a partial response and 24-month progression-free survival in a case study.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Targeted therapies have improved outcomes for advanced non-small-cell lung cancer (NSCLC) with common mutations.
- Uncommon epidermal growth factor receptor (EGFR) mutations, like G719X and L861Q, often confer resistance to standard EGFR tyrosine kinase inhibitors (TKIs).
Observation:
- A 64-year-old female patient with stage IV lung adenocarcinoma (LUAD) presented with symptoms mimicking pneumonia.
- Genetic analysis revealed rare compound mutations in EGFR: G719X and L861Q.
- The patient received afatinib at 40 mg/day without severe adverse events.
Findings:
- The patient achieved a partial response (PR) on CT scans.
- A progression-free survival (PFS) of 24 months was recorded.
- The patient's follow-up is ongoing.
Implications:
- This case supports the efficacy and safety of afatinib for LUAD patients with uncommon EGFR G719X and L861Q compound mutations.
- Afatinib may represent a viable treatment option for patients resistant to other EGFR TKIs.
- Further research into afatinib's role in treating rare EGFR mutations in NSCLC is warranted.
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