Zhang Y, Shen JQ, Shao L, Chen Y, Lei L, Wang JL. Non-small-cell lung cancer with epidermal growth factor receptor L861Q-L833F compound mutation benefits from both afatinib and osimertinib: A case report. World J Clin Cases 2021; 9(27): 8220-8225 [PMID: 34621884 DOI: 10.12998/wjcc.v9.i27.8220]
Corresponding Author of This Article
Jia-Lei Wang, MD, Chief Physician, Department of Medical Oncology, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Shanghai 200032, China. m18017312369@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2021; 9(27): 8220-8225 Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8220
Non-small-cell lung cancer with epidermal growth factor receptor L861Q-L833F compound mutation benefits from both afatinib and osimertinib: A case report
Yao Zhang, Ji-Qiao Shen, Lin Shao, Yan Chen, Lei Lei, Jia-Lei Wang
Yao Zhang, Ji-Qiao Shen, Jia-Lei Wang, Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, China
Yao Zhang, Ji-Qiao Shen, Jia-Lei Wang, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Yao Zhang, Ji-Qiao Shen, Jia-Lei Wang, Institute of Thoracic Oncology, Fudan University, Shanghai 200032, China
Lin Shao, Yan Chen, Lei Lei, Burning Rock Biotech, Guangzhou 510300, Guangdong Province, China
Author contributions: Zhang Y and Wang JL contributed to the conception and design; Zhang Y and Shen JQ contributed to the provision of study materials; Zhang Y, Shen JQ, Chen Y, and Lei L contributed to collection and assembly of the data; Chen Y and Lei L contributed to the experiment methods; Shao L wrote the manuscript; all authors contributed to the revision and final approval of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images in an anonymised manner.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia-Lei Wang, MD, Chief Physician, Department of Medical Oncology, Fudan University Shanghai Cancer Center, No. 270 Dongan Road, Shanghai 200032, China. m18017312369@163.com
Received: May 8, 2021 Peer-review started: May 8, 2021 First decision: June 5, 2021 Revised: June 17, 2021 Accepted: July 5, 2021 Article in press: July 5, 2021 Published online: September 26, 2021 Processing time: 131 Days and 5.7 Hours
Abstract
BACKGROUND
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been adopted as the standard of care for non-small cell lung cancer (NSCLC) patients harboring EGFR sensitizing mutations. Besides the two common mutations exon 19 deletion and L858R, which together comprise approximately 85% of EGFR mutations in NSCLC, rare EGFR mutations also exist, including point mutations, deletions, and insertions spanning EGFR exons 18-25. However, the responsiveness of uncommon EGFR mutations to EGFR TKIs remains elusive and attracts increasing interest.
CASE SUMMARY
Herein, we report a 55-year-old male patient with stage IV NSCLC harboring a rare EGFR L833F-L861Q compound mutation in cis. The patient achieved a partial response to first-line treatment with afatinib and a progression-free survival of 10 mo. After afatinib failure, the patient received multiple line treatments with chemotherapy. Upon disease progression, the heavily pretreated patient was treated with osimertinib and bevacizumab, and both lung lesion and brain metastases were stable for more than 3 mo. He had an overall survival of 25 mo.
CONCLUSION
Our case revealed that both afatinib and the osimertinib + bevacizumab combination demonstrated clinical efficacy in NSCLC harboring an EGFR L833F-L861Q compound mutation. The results provide more therapeutic options for patients with rare compound mutations.
Core Tip: Our case revealed that both afatinib and the osimertinib + bevacizumab combination demonstrated clinical efficacy in a non-small cell lung cancer patient harboring a rare epidermal growth factor receptor (EGFR) L833F-L861Q compound mutation. The results provide more options for the clinical management of patients with rare EGFR compound mutations.
