1. Complete response in a lung adenocarcinoma with pleural metastases initially treated with gefitinib and switched to osimertinib after cerebral oligo-progression with unknown T790M mutation: a case report and review of literature.
- Author
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Hachlaf M, Lkhoyaali S, Nadir W, Lemsyeh H, El Ghissassi B, Mrabti H, Boutayeb S, and Errihani H
- Subjects
- Humans, Male, Aged, Adenocarcinoma of Lung drug therapy, Adenocarcinoma of Lung genetics, Adenocarcinoma of Lung pathology, Carcinoma, Non-Small-Cell Lung drug therapy, Carcinoma, Non-Small-Cell Lung genetics, Carcinoma, Non-Small-Cell Lung pathology, Protein Kinase Inhibitors therapeutic use, Disease Progression, Treatment Outcome, Adenocarcinoma drug therapy, Adenocarcinoma genetics, Adenocarcinoma secondary, Indoles, Pyrimidines, Aniline Compounds therapeutic use, Acrylamides therapeutic use, Lung Neoplasms drug therapy, Lung Neoplasms genetics, Lung Neoplasms pathology, Gefitinib therapeutic use, ErbB Receptors genetics, Brain Neoplasms secondary, Brain Neoplasms drug therapy, Brain Neoplasms genetics, Mutation, Antineoplastic Agents therapeutic use, Pleural Neoplasms secondary, Pleural Neoplasms drug therapy, Pleural Neoplasms genetics
- Abstract
Background: First- and second-generation anti-epithelial growth factor receptor tyrosine kinase inhibitors have shown great efficacy in the treatment of advanced adenocarcinoma with epithelial growth factor receptor mutations, but this efficacy is limited by certain resistance mechanisms, in particular the T790M mutation, which must be screened before second-line treatment with osimertinib is indicated. The search for this mutation is sometimes difficult, especially in cases of intracranial relapse, through this case report we attempt to discuss the possibility of initiating treatment with osimertinib despite an unknown T790M mutation in such situation., Case Report: We present the case of a 70-year-old Moroccan male patient diagnosed with non-small cell lung carcinoma initially metastatic to the pleura with an epithelial growth factor receptor mutation who received gefitinib in first line with a complete response, he subsequently presented with cerebral oligo-progression with extra cranial stability. The patient was started on osimertinib with unknown T790M status, as it was impossible to perform a cerebral biopsy, the evolution was characterized by a partial response followed by stereotactic radiotherapy then a complete response for 2 years., Conclusion: We can discuss osimertinib as an option for patients with stage IV non-small cell lung cancer with brain oligo-progression on prior tyrosine kinase inhibitors and unknown T790M status, further studies are needed in this area., (© 2024. The Author(s).)
- Published
- 2024
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