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A “triple whammy” in adenocarcinoma lung
Osimertinib (AZD9291), a third-generation epidermal growth factor receptor (EGFR)-tyrosine-kinase inhibitor (TKI), is useful in the treatment of non-small cell lung cancer who show resistance to first-generation EGFR-TKIs and harbor T790M mutation. Acquisition of resistance to osimertinib due to sev...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625246/ https://www.ncbi.nlm.nih.gov/pubmed/31290421 http://dx.doi.org/10.4103/lungindia.lungindia_212_18 |
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author | Patro, Mahismita Gothi, Dipti Vaidya, Sameer Sah, Ram Babu |
author_facet | Patro, Mahismita Gothi, Dipti Vaidya, Sameer Sah, Ram Babu |
author_sort | Patro, Mahismita |
collection | PubMed |
description | Osimertinib (AZD9291), a third-generation epidermal growth factor receptor (EGFR)-tyrosine-kinase inhibitor (TKI), is useful in the treatment of non-small cell lung cancer who show resistance to first-generation EGFR-TKIs and harbor T790M mutation. Acquisition of resistance to osimertinib due to several mechanisms has been reported. We report the first case of an Indian patient with osimertinib resistance, due to C797S mutation. A 52-year-old nonsmoker man was detected to have metastatic lung adenocarcinoma (Stage IV) with EGFR exon 19 deletion and treated with erlotinib. After 12 months of response with erlotinib, he developed resistance because of the development of T790M mutation. He was started on osimertinib, with which he responded for 20 months. A follow-up positron emission tomography scan showed progressive disease. Subsequent liquid biopsy did not detect any mutation. However, rebiopsy of the lung lesion showed additional C797S mutation (in cis association with T790M). Hence, the patient was diagnosed to have “triple whammy,” i.e., triple mutation of exon 19 deletion, T790M, and C797S mutations. |
format | Online Article Text |
id | pubmed-6625246 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-66252462019-07-22 A “triple whammy” in adenocarcinoma lung Patro, Mahismita Gothi, Dipti Vaidya, Sameer Sah, Ram Babu Lung India Case Report Osimertinib (AZD9291), a third-generation epidermal growth factor receptor (EGFR)-tyrosine-kinase inhibitor (TKI), is useful in the treatment of non-small cell lung cancer who show resistance to first-generation EGFR-TKIs and harbor T790M mutation. Acquisition of resistance to osimertinib due to several mechanisms has been reported. We report the first case of an Indian patient with osimertinib resistance, due to C797S mutation. A 52-year-old nonsmoker man was detected to have metastatic lung adenocarcinoma (Stage IV) with EGFR exon 19 deletion and treated with erlotinib. After 12 months of response with erlotinib, he developed resistance because of the development of T790M mutation. He was started on osimertinib, with which he responded for 20 months. A follow-up positron emission tomography scan showed progressive disease. Subsequent liquid biopsy did not detect any mutation. However, rebiopsy of the lung lesion showed additional C797S mutation (in cis association with T790M). Hence, the patient was diagnosed to have “triple whammy,” i.e., triple mutation of exon 19 deletion, T790M, and C797S mutations. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6625246/ /pubmed/31290421 http://dx.doi.org/10.4103/lungindia.lungindia_212_18 Text en Copyright: © 2019 Indian Chest Society http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Patro, Mahismita Gothi, Dipti Vaidya, Sameer Sah, Ram Babu A “triple whammy” in adenocarcinoma lung |
title | A “triple whammy” in adenocarcinoma lung |
title_full | A “triple whammy” in adenocarcinoma lung |
title_fullStr | A “triple whammy” in adenocarcinoma lung |
title_full_unstemmed | A “triple whammy” in adenocarcinoma lung |
title_short | A “triple whammy” in adenocarcinoma lung |
title_sort | “triple whammy” in adenocarcinoma lung |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625246/ https://www.ncbi.nlm.nih.gov/pubmed/31290421 http://dx.doi.org/10.4103/lungindia.lungindia_212_18 |
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