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Abstract：
The paradigm for the pharmacological management of advanced non-small cell lung cancer (NSCLC) has been revolutionized by the development of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). Developing resistance to target therapy is unavoidable. Mostly, treatments for single molecular alteration after acquiring EGFR-TKI treatment resistance are well studied. However, there is limited evidence of treatment strategies for complex resistance mechanisms. Presented here is a case of an EGFR-mutated NSCLC patient who developed a complex resistance profile: T790M point mutation and EGFR amplification after first-line EGFR-TKI. This patient was safely treated with a combination of osimertinib and icotinib and achieved a significant clinical response and clear molecular response. Here we present the clinical evidence of the efficacy of osimertinib combined with icotinib in the treatment of EGFR classical mutation along with resistant mutation of T790M point mutation and EGFR amplification.
摘要：
表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKIs）的开发彻底改变了晚期非小细胞肺癌（NSCLC）的药理学管理范式。发展对靶向治疗的抗性是不可避免的。大多数情况下,对获得EGFR-TKI治疗耐药后的单分子改变的治疗方法进行了很好的研究。然而,复杂耐药机制的治疗策略证据有限.本文介绍的是EGFR突变的NSCLC患者，其在一线EGFR-TKI后出现了复杂的耐药谱：T790M点突变和EGFR扩增。该患者使用奥希替尼和埃克替尼的组合安全治疗，并获得了显着的临床反应和明确的分子反应。在这里，我们提供了奥希替尼联合埃克替尼治疗EGFR经典突变以及T790M点突变和EGFR扩增的耐药突变的临床证据。
