Čoupková Helena, Vyzula Rostislav
Klin Onkol. 2018 Fall;31(5):380-383. doi: 10.14735/amko2018380.
Exon 18-T719X EGFR mutation in non-small cell lung cancer is rare, only 1-5% of all EGFR mutations. The efficacy of EGFR tyrosin kinase inhibitors in tumours with uncommon mutations is still unclear and the prediction of response of such tumours to therapy remains unexplored.
A 71-year-old woman with no previous smoking history with disseminated lung adenocarcinoma with exon 18-T719X EGFR mutation was treated with afatinib. A partial response was achieved in 2 months, progression-free survival was 19 months. The dose of afatinib was reduced to 30mg/day after 3 months due to skin toxicity and stomatitis grade 2. Next reduction to 20mg/day was performed after 10 subsequent months due to leucopenia and neutropenia grade 2.
With this patient, a partial response which lasted 19 months despite 50% reduction of the afatinib dose was achieved. Key words: afatinib - non-small cell lung cancer - epidermal growth factor-mutation receptor - treatment outcome - drug toxicity This article was supported by Boehringer Ingelheim. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 27. 9. 2018 Accepted: 1. 10. 2018.
非小细胞肺癌中外显子18-T719X表皮生长因子受体(EGFR)突变罕见,仅占所有EGFR突变的1%-5%。EGFR酪氨酸激酶抑制剂在具有罕见突变的肿瘤中的疗效仍不明确,且此类肿瘤对治疗反应的预测尚待探索。
一名71岁无吸烟史的女性,患有伴有外显子18-T719X EGFR突变的播散性肺腺癌,接受了阿法替尼治疗。2个月时获得部分缓解,无进展生存期为19个月。3个月后因2级皮肤毒性和口腔炎将阿法替尼剂量减至30mg/天。随后10个月后因2级白细胞减少和中性粒细胞减少将剂量进一步减至20mg/天。
该患者尽管阿法替尼剂量降低了50%,仍获得了持续19个月的部分缓解。关键词:阿法替尼-非小细胞肺癌-表皮生长因子突变受体-治疗结果-药物毒性 本文得到勃林格殷格翰公司的支持。作者声明他们在研究中使用的药物、产品或服务方面不存在潜在利益冲突。编辑委员会声明该手稿符合国际医学期刊编辑委员会(ICMJE)对生物医学论文的推荐要求。提交日期:2018年9月27日 接受日期:2018年10月1日