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Luo Y, Lin L, Shufeng C, Liu C, Li Z, Liu K. Osimertinib treatment response in a patient with lung adenocarcinoma harboring two rare EGFR mutations: A case report. Oncol Lett 2024; 28:501. [PMID: 39233826 PMCID: PMC11369848 DOI: 10.3892/ol.2024.14634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 07/25/2024] [Indexed: 09/06/2024] Open
Abstract
Epidermal growth factor receptor (EGFR) mutations have emerged as the most well-studied oncogenic alterations in advanced non-small cell lung cancer. The presence of single common or rare EGFR mutations and extra complex EGFR mutations correlates with the response sensitivity to EGFR tyrosine kinase inhibitors. Therefore, given the lack of evidence for the emergence of rare EGFR mutation types, the pathogenic mechanisms of uncommon EGFR mutations and the optimal treatment strategies remain to be explored further. The present study describes the case of a patient diagnosed with lung adenocarcinoma (LUAD) carrying two rare EGFR exon 18 indel/G719C and exon 19 L747S mutations, in which persistent lesion shrinkage was exhibited within 16 months of osimertinib treatment. Given the paucity of clinical trials for the treatment of LUAD harboring complex EGER mutations, the present detailed case description may provide clinicians with effective clinical experience in treating patients.
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Affiliation(s)
- Yawen Luo
- Department of Oncology, The First Affiliated Hospital of Shenzhen University, The Second People's Hospital of Shenzhen, Shenzhen, Guangdong 518035, P.R. China
| | - Lin Lin
- Department of Oncology, The First Affiliated Hospital of Shenzhen University, The Second People's Hospital of Shenzhen, Shenzhen, Guangdong 518035, P.R. China
| | - Chen Shufeng
- Department of Internal Medicine-Oncology, Dongguan Wangniudun Hospital, Dongguan, Guangdong 518131, P.R. China
| | - Chun Liu
- Dongguan Institute of Clinical Cancer Research, Dongguan Key Laboratory of Precision Diagnosis and Treatment for Tumors, The Tenth Affiliated Hospital of Southern Medical University, Dongguan People's Hospital, Dongguan, Guangdong 518131, P.R. China
| | - Zhuanghua Li
- Dongguan Institute of Clinical Cancer Research, Dongguan Key Laboratory of Precision Diagnosis and Treatment for Tumors, The Tenth Affiliated Hospital of Southern Medical University, Dongguan People's Hospital, Dongguan, Guangdong 518131, P.R. China
| | - Kejun Liu
- Dongguan Institute of Clinical Cancer Research, Dongguan Key Laboratory of Precision Diagnosis and Treatment for Tumors, The Tenth Affiliated Hospital of Southern Medical University, Dongguan People's Hospital, Dongguan, Guangdong 518131, P.R. China
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Li Y, Mao T, Wang J, Zheng H, Hu Z, Cao P, Yang S, Zhu L, Guo S, Zhao X, Tian Y, Shen H, Lin F. Toward the next generation EGFR inhibitors: an overview of osimertinib resistance mediated by EGFR mutations in non-small cell lung cancer. Cell Commun Signal 2023; 21:71. [PMID: 37041601 PMCID: PMC10088170 DOI: 10.1186/s12964-023-01082-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 02/14/2023] [Indexed: 04/13/2023] Open
Abstract
Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is currently the standard first-line therapy for EGFR-mutated advanced non-small cell lung cancer (NSCLC). The life quality and survival of this subgroup of patients were constantly improving owing to the continuous iteration and optimization of EGFR-TKI. Osimertinib, an oral, third-generation, irreversible EGFR-TKI, was initially approved for the treatment of NSCLC patients carrying EGFR T790M mutations, and has currently become the dominant first-line targeted therapy for most EGFR mutant lung cancer. Unfortunately, resistance to osimertinib inevitably develops during the treatment and therefore limits its long-term effectiveness. For both fundamental and clinical researchers, it stands for a major challenge to reveal the mechanism, and a dire need to develop novel therapeutics to overcome the resistance. In this article, we focus on the acquired resistance to osimertinib caused by EGFR mutations which account for approximately 1/3 of all reported resistance mechanisms. We also review the proposed therapeutic strategies for each type of mutation conferring resistance to osimertinib and give an outlook to the development of the next generation EGFR inhibitors. Video Abstract.
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Affiliation(s)
- Yufeng Li
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
| | - Tianyu Mao
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jing Wang
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Hongrui Zheng
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Ziyi Hu
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Pingping Cao
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Suisui Yang
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Lingyun Zhu
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Shunyao Guo
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Xinfei Zhao
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Yue Tian
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China
- Department of Cell Biology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, Jiangsu, China
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China
| | - Hua Shen
- Department of Medical Oncology, The Affiliated Sir Run Run Hospital of Nanjing Medical University, XueHai Building A111, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu, China.
| | - Fan Lin
- Institute for Brain Tumors and Key Laboratory of Rare Metabolic Diseases, Nanjing Medical University, Nanjing, Jiangsu, China.
- Department of Gastroenterology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, Henan, China.
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