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Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation
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| Zeitschriftentitel: | Frontiers in Oncology |
|---|---|
| Personen und Körperschaften: | , , , , , , |
| In: | Frontiers in Oncology, 10, 2021 |
| Format: | E-Article |
| Sprache: | Unbestimmt |
| veröffentlicht: |
Frontiers Media SA
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| Schlagwörter: |
| author_facet |
Zöchbauer-Müller, Sabine Kaserer, Bettina Prosch, Helmut Cseh, Agnieszka Solca, Flavio Bauer, Markus Johann Müllauer, Leonhard Zöchbauer-Müller, Sabine Kaserer, Bettina Prosch, Helmut Cseh, Agnieszka Solca, Flavio Bauer, Markus Johann Müllauer, Leonhard |
|---|---|
| author |
Zöchbauer-Müller, Sabine Kaserer, Bettina Prosch, Helmut Cseh, Agnieszka Solca, Flavio Bauer, Markus Johann Müllauer, Leonhard |
| spellingShingle |
Zöchbauer-Müller, Sabine Kaserer, Bettina Prosch, Helmut Cseh, Agnieszka Solca, Flavio Bauer, Markus Johann Müllauer, Leonhard Frontiers in Oncology Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation Cancer Research Oncology |
| author_sort |
zöchbauer-müller, sabine |
| spelling |
Zöchbauer-Müller, Sabine Kaserer, Bettina Prosch, Helmut Cseh, Agnieszka Solca, Flavio Bauer, Markus Johann Müllauer, Leonhard 2234-943X Frontiers Media SA Cancer Research Oncology http://dx.doi.org/10.3389/fonc.2020.593852 <jats:p>Unlike most other primary epidermal growth factor receptor (<jats:italic>EGFR</jats:italic>) mutations in non-small cell lung cancer (NSCLC), exon 20 insertions, comprising approximately 4% to 10% of all <jats:italic>EGFR</jats:italic> mutations, are generally considered to be resistant to EGFR tyrosine kinase inhibitors (TKIs). However, <jats:italic>EGFR</jats:italic> exon 20 insertions are structurally and pharmacologically heterogeneous, with variability in their position and size having implications for response to different EGFR TKIs. The second-generation ErbB family blocker, afatinib, is approved for the first-line treatment of <jats:italic>EGFR</jats:italic> mutation-positive NSCLC and has been shown to have a broad inhibitory profile against common and uncommon <jats:italic>EGFR</jats:italic> mutations. Here, we describe a patient with bilateral multifocal lung adenocarcinoma harboring a very rare <jats:italic>EGFR</jats:italic> exon 20 insertion (c.2317_2319dup3; p.H773dup), who has been receiving treatment with afatinib for 4.5 years. To our knowledge, this is the first report describing long-term benefit for a patient treated with afatinib with this rare exon 20 insertion. We are aware of two further cases with this rare <jats:italic>EGFR</jats:italic> mutation. One patient, also reported here, has early-stage lung adenocarcinoma and has not yet received systemic therapy for NSCLC. The other patient received afatinib in the context of a global compassionate use program and had progressive disease. Our findings may be of clinical relevance for patients carrying tumors with this rare mutation as epidemiological evidence suggests that p.H773dup may function as a driver mutation in NSCLC. Together with previous preclinical and clinical evidence for the activity of afatinib against certain <jats:italic>EGFR</jats:italic> exon 20 insertions, these findings warrant further investigation.</jats:p> Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation Frontiers in Oncology |
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| title |
Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_unstemmed |
Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_full |
Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_fullStr |
Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_full_unstemmed |
Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_short |
Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_sort |
case report: afatinib treatment in a patient with nsclc harboring a rare egfr exon 20 mutation |
| topic |
Cancer Research Oncology |
| url |
http://dx.doi.org/10.3389/fonc.2020.593852 |
| publishDate |
2021 |
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|
| description |
<jats:p>Unlike most other primary epidermal growth factor receptor (<jats:italic>EGFR</jats:italic>) mutations in non-small cell lung cancer (NSCLC), exon 20 insertions, comprising approximately 4% to 10% of all <jats:italic>EGFR</jats:italic> mutations, are generally considered to be resistant to EGFR tyrosine kinase inhibitors (TKIs). However, <jats:italic>EGFR</jats:italic> exon 20 insertions are structurally and pharmacologically heterogeneous, with variability in their position and size having implications for response to different EGFR TKIs. The second-generation ErbB family blocker, afatinib, is approved for the first-line treatment of <jats:italic>EGFR</jats:italic> mutation-positive NSCLC and has been shown to have a broad inhibitory profile against common and uncommon <jats:italic>EGFR</jats:italic> mutations. Here, we describe a patient with bilateral multifocal lung adenocarcinoma harboring a very rare <jats:italic>EGFR</jats:italic> exon 20 insertion (c.2317_2319dup3; p.H773dup), who has been receiving treatment with afatinib for 4.5 years. To our knowledge, this is the first report describing long-term benefit for a patient treated with afatinib with this rare exon 20 insertion. We are aware of two further cases with this rare <jats:italic>EGFR</jats:italic> mutation. One patient, also reported here, has early-stage lung adenocarcinoma and has not yet received systemic therapy for NSCLC. The other patient received afatinib in the context of a global compassionate use program and had progressive disease. Our findings may be of clinical relevance for patients carrying tumors with this rare mutation as epidemiological evidence suggests that p.H773dup may function as a driver mutation in NSCLC. Together with previous preclinical and clinical evidence for the activity of afatinib against certain <jats:italic>EGFR</jats:italic> exon 20 insertions, these findings warrant further investigation.</jats:p> |
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| description | <jats:p>Unlike most other primary epidermal growth factor receptor (<jats:italic>EGFR</jats:italic>) mutations in non-small cell lung cancer (NSCLC), exon 20 insertions, comprising approximately 4% to 10% of all <jats:italic>EGFR</jats:italic> mutations, are generally considered to be resistant to EGFR tyrosine kinase inhibitors (TKIs). However, <jats:italic>EGFR</jats:italic> exon 20 insertions are structurally and pharmacologically heterogeneous, with variability in their position and size having implications for response to different EGFR TKIs. The second-generation ErbB family blocker, afatinib, is approved for the first-line treatment of <jats:italic>EGFR</jats:italic> mutation-positive NSCLC and has been shown to have a broad inhibitory profile against common and uncommon <jats:italic>EGFR</jats:italic> mutations. Here, we describe a patient with bilateral multifocal lung adenocarcinoma harboring a very rare <jats:italic>EGFR</jats:italic> exon 20 insertion (c.2317_2319dup3; p.H773dup), who has been receiving treatment with afatinib for 4.5 years. To our knowledge, this is the first report describing long-term benefit for a patient treated with afatinib with this rare exon 20 insertion. We are aware of two further cases with this rare <jats:italic>EGFR</jats:italic> mutation. One patient, also reported here, has early-stage lung adenocarcinoma and has not yet received systemic therapy for NSCLC. The other patient received afatinib in the context of a global compassionate use program and had progressive disease. Our findings may be of clinical relevance for patients carrying tumors with this rare mutation as epidemiological evidence suggests that p.H773dup may function as a driver mutation in NSCLC. Together with previous preclinical and clinical evidence for the activity of afatinib against certain <jats:italic>EGFR</jats:italic> exon 20 insertions, these findings warrant further investigation.</jats:p> |
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| spelling | Zöchbauer-Müller, Sabine Kaserer, Bettina Prosch, Helmut Cseh, Agnieszka Solca, Flavio Bauer, Markus Johann Müllauer, Leonhard 2234-943X Frontiers Media SA Cancer Research Oncology http://dx.doi.org/10.3389/fonc.2020.593852 <jats:p>Unlike most other primary epidermal growth factor receptor (<jats:italic>EGFR</jats:italic>) mutations in non-small cell lung cancer (NSCLC), exon 20 insertions, comprising approximately 4% to 10% of all <jats:italic>EGFR</jats:italic> mutations, are generally considered to be resistant to EGFR tyrosine kinase inhibitors (TKIs). However, <jats:italic>EGFR</jats:italic> exon 20 insertions are structurally and pharmacologically heterogeneous, with variability in their position and size having implications for response to different EGFR TKIs. The second-generation ErbB family blocker, afatinib, is approved for the first-line treatment of <jats:italic>EGFR</jats:italic> mutation-positive NSCLC and has been shown to have a broad inhibitory profile against common and uncommon <jats:italic>EGFR</jats:italic> mutations. Here, we describe a patient with bilateral multifocal lung adenocarcinoma harboring a very rare <jats:italic>EGFR</jats:italic> exon 20 insertion (c.2317_2319dup3; p.H773dup), who has been receiving treatment with afatinib for 4.5 years. To our knowledge, this is the first report describing long-term benefit for a patient treated with afatinib with this rare exon 20 insertion. We are aware of two further cases with this rare <jats:italic>EGFR</jats:italic> mutation. One patient, also reported here, has early-stage lung adenocarcinoma and has not yet received systemic therapy for NSCLC. The other patient received afatinib in the context of a global compassionate use program and had progressive disease. Our findings may be of clinical relevance for patients carrying tumors with this rare mutation as epidemiological evidence suggests that p.H773dup may function as a driver mutation in NSCLC. Together with previous preclinical and clinical evidence for the activity of afatinib against certain <jats:italic>EGFR</jats:italic> exon 20 insertions, these findings warrant further investigation.</jats:p> Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation Frontiers in Oncology |
| spellingShingle | Zöchbauer-Müller, Sabine, Kaserer, Bettina, Prosch, Helmut, Cseh, Agnieszka, Solca, Flavio, Bauer, Markus Johann, Müllauer, Leonhard, Frontiers in Oncology, Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation, Cancer Research, Oncology |
| title | Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_full | Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_fullStr | Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_full_unstemmed | Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_short | Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| title_sort | case report: afatinib treatment in a patient with nsclc harboring a rare egfr exon 20 mutation |
| title_unstemmed | Case Report: Afatinib Treatment in a Patient With NSCLC Harboring a Rare EGFR Exon 20 Mutation |
| topic | Cancer Research, Oncology |
| url | http://dx.doi.org/10.3389/fonc.2020.593852 |