PDF(Pubmed)
Abstract：
UNASSIGNED: Mutation in Kristin ras sarcoma virus (KRAS) oncogene is the main driver in pancreatic ductal adenocarcinoma (PDAC) and is present in nearly 90% of patients with PDAC. Epidermal growth factor receptor (EGFR) mutation is rare in PDAC and is mostly present in the absence of KRAS mutation. Co-occurrence of KRAS and EGFR mutations is extremely rare, and the value of EGFR inhibition in these cases is unknown.
UNASSIGNED: Here, we present a case of metastatic PDAC with co-occurrence of KRAS G12V and EGFR L730R. Despite primary resistance to folinic acid, fluorouracil, irinotecan, oxaliplatin, and gemcitabine/nab-paclitaxel, this patient had a biochemical response (decrease in carbohydrate antigen 19-9) and disease control of 7 months on gemcitabine/erlotinib (an EGFR inhibitor). This outcome is remarkable in the late-line PDAC treatment setting and is unusual after the progression of the tumor on gemcitabine/nab-paclitaxel chemotherapy.
UNASSIGNED: This case suggests that gemcitabine/erlotinib could be an effective treatment in patients with PDAC and co-occurrence of EGFR and KRAS mutations.
UNASSIGNED: Here, we present a case of metastatic PDAC with co-occurrence of KRAS G12V and EGFR L730R. Despite primary resistance to folinic acid, fluorouracil, irinotecan, oxaliplatin, and gemcitabine/nab-paclitaxel, this patient had a biochemical response (decrease in carbohydrate antigen 19-9) and disease control of 7 months on gemcitabine/erlotinib (an EGFR inhibitor). This outcome is remarkable in the late-line PDAC treatment setting and is unusual after the progression of the tumor on gemcitabine/nab-paclitaxel chemotherapy.
UNASSIGNED: This case suggests that gemcitabine/erlotinib could be an effective treatment in patients with PDAC and co-occurrence of EGFR and KRAS mutations.
摘要：
■克里斯汀拉斯肉瘤病毒（KRAS）癌基因的突变是胰腺导管腺癌（PDAC）的主要驱动因素，并且存在于近90％的PDAC患者中。表皮生长因子受体（EGFR）突变在PDAC中很少见，并且大多数存在于不存在KRAS突变的情况下。KRAS和EGFR突变的同时发生极为罕见，在这些病例中EGFR抑制的价值未知。
■这里，我们介绍了一例伴有KRASG12V和EGFRL730R的转移性PDAC。尽管对亚叶酸的主要抗性，氟尿嘧啶,伊立替康,奥沙利铂,和吉西他滨/nab-紫杉醇，该患者接受吉西他滨/厄洛替尼(一种EGFR抑制剂)治疗后生化应答(糖类抗原19-9降低),疾病控制7个月.该结果在后期的PDAC治疗环境中是显著的,并且在吉西他滨/nab-紫杉醇化疗的肿瘤进展之后是不寻常的。
■该病例提示吉西他滨/埃罗替尼可有效治疗PDAC并同时出现EGFR和KRAS突变的患者。
■这里，我们介绍了一例伴有KRASG12V和EGFRL730R的转移性PDAC。尽管对亚叶酸的主要抗性，氟尿嘧啶,伊立替康,奥沙利铂,和吉西他滨/nab-紫杉醇，该患者接受吉西他滨/厄洛替尼(一种EGFR抑制剂)治疗后生化应答(糖类抗原19-9降低),疾病控制7个月.该结果在后期的PDAC治疗环境中是显著的,并且在吉西他滨/nab-紫杉醇化疗的肿瘤进展之后是不寻常的。
■该病例提示吉西他滨/埃罗替尼可有效治疗PDAC并同时出现EGFR和KRAS突变的患者。
