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Primary resistance to osimertinib despite acquired T790M
Primary resistance to osimertinib despite acquired T790M
- Source :
- Respirology Case Reports, Respirology Case Reports, Vol 8, Iss 2, Pp n/a-n/a (2020)
- Publication Year :
- 2020
- Publisher :
- John Wiley & Sons, Ltd, 2020.
-
Abstract
- Current National Comprehensive Cancer Network (NCCN) guidelines suggest plasma‐based testing (liquid biopsy) for T790M in epidermal growth factor receptor (EGFR)‐mutated non‐small cell lung carcinoma (NSCLC) with acquired resistance to first‐/second‐generation EGFR tyrosine kinase inhibitors (TKIs). Positivity for resistant mutation on liquid biopsy may obviate the need for invasive tissue biopsy. We report a rare case of primary resistance to osimertinib, although liquid biopsy revealed EGFR T790M positivity. A 63‐year‐old male, never smoker, was diagnosed with stage IV lung adenocarcinoma with EGFR exon 19 deletion. Treatment started with erlotinib and was continued for 15 months until disease progression. Osimertinib was initiated when liquid biopsy showed EGFR T790M positivity. However, primary resistance to osimertinib was noted on follow‐up imaging. Re‐biopsy revealed small cell lung cancer. Detection of T790M via liquid biopsy among NSCLC patients with acquired resistance to EGFR‐TKI might miss other possible resistant mechanisms. Tissue biopsy should be considered to exclude small cell lung carcinoma (SCLC) transformation.<br />Liquid biopsy to diagnose T790M presence in non‐small cell lung carcinoma (NSCLC) patients resistant to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR‐TKI) might miss other possible resistance mechanisms. Tissue biopsy should be considered to exclude the presence of small cell lung carcinoma (SCLC) transformation.
- Subjects :
- Pulmonary and Respiratory Medicine
Oncology
medicine.medical_specialty
Case Report
Case Reports
small cell transformation
T790M
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Carcinoma
Osimertinib
primary resistance
Liquid biopsy
lcsh:RC705-779
business.industry
Cancer
lcsh:Diseases of the respiratory system
medicine.disease
respiratory tract diseases
030228 respiratory system
030220 oncology & carcinogenesis
osimertinib
Adenocarcinoma
Small Cell Lung Carcinoma
Erlotinib
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20513380
- Volume :
- 8
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Respirology Case Reports
- Accession number :
- edsair.doi.dedup.....0406582e3fb5589b1913ab7d80462709