PDF(Pubmed)
Abstract：
BACKGROUND: Acquired resistance still inevitably occurs in patients treated with third-generation TKI osimertinib. Although the EGFR L718Q mutation has been reported as a scarce mechanism of osimertinib resistance, advanced therapeutic strategies are still in development. In this report, we included 2 cases of patients who acquired EGFR L858R/L718Q mutation after osimertinib and were overcome by dacomitinib.
METHODS: Case 1: A 77-year-old woman was diagnosed with stage IV lung adenocarcinoma. Case 2: A 64-year-old woman was diagnosed with stage IV lung adenocarcinoma.
METHODS: Case 1: The patient was diagnosed with adenocarcinoma with EGFR L858R mutation. Since then, treatment with gefitinib was administrated, leading to a progression-free survival of 18 months. The treatment was switched to osimertinib based on the detection of EGFR T790M mutation, resulting in a progression-free survival of 24 months. Subsequently, EGFR L718Q mutation was detected. Case 2: The patient was diagnosed with adenocarcinoma with EGFR L858R mutation. Icotinib was used as the first-line treatment for 7 months. Osimertinib was applied as the second-line treatment for 13 months based on the EGFR T790M mutation. Subsequently, EGFR L718Q mutation was detected.
METHODS: Case 1: Dacomitinib was administered. Case 2: Dacomitinib was administered.
RESULTS: Case 1:The progression-free survival was 8 months. Case 2: The progression-free survival was 3 months.
CONCLUSIONS: Dacomitinib is a potential treatment option for NSCLC patients with EGFR L718Q mutation after resistance to Osimertinib. Further research is needed to validate the efficacy of Dacomitinib in this context.
METHODS: Case 1: A 77-year-old woman was diagnosed with stage IV lung adenocarcinoma. Case 2: A 64-year-old woman was diagnosed with stage IV lung adenocarcinoma.
METHODS: Case 1: The patient was diagnosed with adenocarcinoma with EGFR L858R mutation. Since then, treatment with gefitinib was administrated, leading to a progression-free survival of 18 months. The treatment was switched to osimertinib based on the detection of EGFR T790M mutation, resulting in a progression-free survival of 24 months. Subsequently, EGFR L718Q mutation was detected. Case 2: The patient was diagnosed with adenocarcinoma with EGFR L858R mutation. Icotinib was used as the first-line treatment for 7 months. Osimertinib was applied as the second-line treatment for 13 months based on the EGFR T790M mutation. Subsequently, EGFR L718Q mutation was detected.
METHODS: Case 1: Dacomitinib was administered. Case 2: Dacomitinib was administered.
RESULTS: Case 1:The progression-free survival was 8 months. Case 2: The progression-free survival was 3 months.
CONCLUSIONS: Dacomitinib is a potential treatment option for NSCLC patients with EGFR L718Q mutation after resistance to Osimertinib. Further research is needed to validate the efficacy of Dacomitinib in this context.
摘要：
背景：在使用第三代TKI奥希替尼治疗的患者中，获得性耐药仍然不可避免地发生。尽管EGFRL718Q突变已被报道为奥希替尼耐药的稀缺机制，先进的治疗策略仍在发展中。在这份报告中,我们纳入了2例奥希替尼后获得EGFRL858R/L718Q突变并被达克替尼克服的患者.
方法：案例1：一名77岁女性被诊断为IV期肺腺癌。病例2：一名64岁的女性被诊断为IV期肺腺癌。
方法：病例1：患者诊断为EGFRL858R突变腺癌。从那以后,给予吉非替尼治疗，导致18个月的无进展生存期。根据EGFRT790M突变的检测，将治疗改为奥希替尼，导致24个月的无进展生存期。随后，检测到EGFRL718Q突变。病例2：患者诊断为EGFRL858R突变腺癌。伊克替尼作为一线治疗7个月。基于EGFRT790M突变，奥希替尼作为二线治疗13个月。随后，检测到EGFRL718Q突变。
方法：病例1：给予达克替尼。案例2：给予达科替尼。
结果：病例1：无进展生存期为8个月。病例2：无进展生存期为3个月。
结论：达科替尼是对奥希替尼耐药后EGFRL718Q突变的NSCLC患者的潜在治疗选择。在这种情况下，需要进一步的研究来验证达科替尼的疗效。
方法：案例1：一名77岁女性被诊断为IV期肺腺癌。病例2：一名64岁的女性被诊断为IV期肺腺癌。
方法：病例1：患者诊断为EGFRL858R突变腺癌。从那以后,给予吉非替尼治疗，导致18个月的无进展生存期。根据EGFRT790M突变的检测，将治疗改为奥希替尼，导致24个月的无进展生存期。随后，检测到EGFRL718Q突变。病例2：患者诊断为EGFRL858R突变腺癌。伊克替尼作为一线治疗7个月。基于EGFRT790M突变，奥希替尼作为二线治疗13个月。随后，检测到EGFRL718Q突变。
方法：病例1：给予达克替尼。案例2：给予达科替尼。
结果：病例1：无进展生存期为8个月。病例2：无进展生存期为3个月。
结论：达科替尼是对奥希替尼耐药后EGFRL718Q突变的NSCLC患者的潜在治疗选择。在这种情况下，需要进一步的研究来验证达科替尼的疗效。
