Osimertinib as Salvage Therapy in Advanced Non-Small Cell Lung Cancer After Aumolertinib Resistance With T790M...

Area of Science:

• Oncology
• Pharmacology

Background:

• Third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are standard for EGFR-mutant non-small cell lung cancer (NSCLC).
• Multiple third-generation EGFR-TKIs are available, raising questions about comparative efficacy and optimal patient selection.

Purpose of the Study:

• To report a case of advanced NSCLC with brain metastases treated with sequential third-generation EGFR-TKIs.
• To evaluate the efficacy of aumolertinib followed by osimertinib in an EGFR-mutant NSCLC patient.

Main Methods:

• Case report of an advanced NSCLC patient with EGFR L858R and T790M mutations.
• Initial treatment with pemetrexed plus carboplatin, followed by aumolertinib, and then osimertinib upon disease progression and intracranial metastasis.

Main Results:

• Aumolertinib treatment led to disease progression and worsening brain metastases.
• Switching to osimertinib resulted in symptom relief and a progression-free survival of nearly 2 years.
• The patient was diagnosed with leptomeningeal metastasis and died 4 months after osimertinib resistance.

Conclusions:

• Osimertinib may be a viable treatment option for EGFR-mutant NSCLC patients who have failed aumolertinib.
• Osimertinib may be particularly beneficial for patients with intracranial metastases.