Osimertinib for an Advanced NSCLC Patient with Two Common EGFR Mutations and a Concomitant MET Exon 14 Skipping Mutation: A Case Report

Zhicong Liu,1,* Pengtao Song,2,* Lingyan Zhou,1 Dongxiang Ji,1 Hui Shen,1 Hui Dong,1 Xueren Feng1 1Department of Respiratory Medicine, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, People’s Republic of China; 2Department of Pathology, Huzhou Central Hospital, Affiliated Central Hospital Huzhou University, Huzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hui Dong; Xueren Feng, Department of Respiratory Medicine, Huzhou Centre Hospital, Affiliated Centre Hospital Huzhou University, Huzhou, People’s Republic of China, Email 1150861366@qq.com; fxr9301006@163.comBackground: Lung cancer remains the leading cause of cancer-related mortality. Studies have revealed that a combination of crizotinib and EGFR tyrosine kinase inhibitors (TKIs) could be an effective treatment option for patients with sensitizing EGFR mutations and de novo or acquired MET amplification. Until now, there have been few reports of the response in patients harboring three mutations.Case Presentation: A patient was diagnosed with advanced lung adenocarcinoma harboring EGFR Del19, L858R mutation and METex14. She received osimertinib, and repeated imaging revealed further tumor progression. Sixty-six days later, combined treatment with osimertinib and crizotinib was initiated. Unfortunately, the patient succumbed to death at home after 17 days.Conclusion: This report firstly provided a lung adenocarcinoma patient with two common EGFR mutations (Del19 and L858R) and METex14. Our case raises a reminder about the tolerance and safety of combination therapy, especially in older peoples.Keywords: lung adenocarcinoma, compound mutations, osimertinib, crizotinib, combination therapy, case report