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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...

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Autores principales: Patro, Mahismita, Gothi, Dipti, Vaidya, Sameer, Sah, Ram Babu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2019
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.
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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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