Advanced lung adenocarcinoma harboring uncommon EGFR 19 Del and T790M/trans-C797S mutations after resistance: a case
Yuting Xiao1, Dunqiang Ren1, Huanhuan Bi1
1Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
Abstract:
The most common epidermal growth factor receptor (EGFR) mutation in non-small cell lung cancer (NSCLC) is exon 19 deletion (19del), which is sensitive to EGFR tyrosine kinase inhibitors (EGFR-TKIs). However, uncommon EGFR 19del mutations exhibit varied responses to EGFR-TKI treatment. Research and clinical data on these uncommon subtypes are limited. Additionally, resistance to EGFR-TKIs is inevitable. EGFR C797S is a frequent mechanism of resistance to third-generation EGFR-TKIs, usually occurs in cis with T790M and in 5% of patients in trans. Here, we report a patient diagnosed with lung adenocarcinoma harboring EGFR 19Del L747-A755delinsSKD mutation with co-occurring T790M and trans-C797S mutations, who showed a positive response to combination therapy with first- and third-generation TKIs. This case report suggests an effective treatment option for such patients.
Insights
This case report details a lung cancer patient with a rare EGFR mutation (19Del L747-A755delinsSKD) and resistance mutations (T790M and trans-C797S). Combination therapy with first- and third-generation EGFR tyrosine kinase inhibitors (TKIs) proved effective.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Epidermal growth factor receptor (EGFR) mutations drive non-small cell lung cancer (NSCLC).
- Exon 19 deletions (19del) are common EGFR mutations sensitive to EGFR tyrosine kinase inhibitors (TKIs).
- Uncommon EGFR 19del subtypes and resistance mechanisms like EGFR C797S present treatment challenges.
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