1. Dramatic response to osimertinib combined with crizotinib in EGFR T790 M mutation only in blood and Met amplification only in tumor tissue expressive non-small cell lung cancer: A case report.
- Author
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Li D, Gui Q, Xu C, Shen M, and Chen K
- Subjects
- Acrylamides therapeutic use, Aniline Compounds therapeutic use, Antineoplastic Agents adverse effects, Antineoplastic Agents therapeutic use, Crizotinib therapeutic use, ErbB Receptors drug effects, High-Throughput Nucleotide Sequencing methods, Humans, Male, Middle Aged, Tomography, X-Ray Computed methods, Acrylamides adverse effects, Aniline Compounds adverse effects, Carcinoma, Non-Small-Cell Lung drug therapy, Crizotinib adverse effects
- Abstract
Rationale: Besides the T790 M mutation, it may coexist with bypass pathway activation in real clinical cases for patients with EGFR mutations who resisted to the first- and second-generation tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC). There are limited clinical trial data describing the efficacy of osimertinib combined with MET inhibition in EGFR T790M-mutant NSCLC patients with Met amplification., Patient Concerns: A non-smoking 53-year-old male patient with lung adenocarcinoma underwent gefitinib, afatinib, and osimertinib combined with crizotinib treatment and developed different EGFR resistance mutations., Diagnoses: The patient was diagnosed with lung adenocarcinoma (stage cT4N2M0, IIIB). After resistance to the therapy targeting EGFR exon 21 L858R point mutation, T790 M mutation was detected in liquid biopsy and Met amplification was detected via tissue biopsy by next-generation sequencing (NGS)., Interventions: The patient received systemic treatments, including chemotherapy, gefitinib, afatinib, and osimertinib combined with crizotinib., Outcomes: The patient died of multisystem organ failure and had an overall survival of 24 months., Lessons: Although osimertinib combined with crizotinib therapy showed dramatic tumor shrinkage in both the primary tumor and bone metastasis to an EGFR T790M-mutant NSCLC patient with MET amplification, the progression-free survival (PFS) was only two months., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
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