%0 Journal Article
%T Dacomitinib overcomes acquired resistance to osimertinib in advanced NSCLC patients with EGFR L718Q mutation: A two-case report.
%A Li J
%A Jin M
%A Diao Y
%A Li X
%J Medicine (Baltimore)
%V 103
%N 28
%D 2024 Jul 12
%M 38996163
%F 1.817
%R 10.1097/MD.0000000000038789
%X <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>METHODS: </B>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.<BR><B>METHODS: </B>Case 1: Dacomitinib was administered. Case 2: Dacomitinib was administered.<BR><B>RESULTS: </B>Case 1:The progression-free survival was 8 months. Case 2: The progression-free survival was 3 months.<BR><B>CONCLUSIONS: </B>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.