Zhou Juan, Zhou Fei, Xie Huikang, Wu Yan, Zhao Jing, Su Chunxia
Department of Medical Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai 200433, China.
Department of Pathology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai 200433, China.
Transl Lung Cancer Res. 2020 Apr;9(2):354-359. doi: 10.21037/tlcr.2020.02.09.
The clinical activity and favorable toxicity profile of osimertinib has led it to be approved not only for advanced non-small cell lung cancer (NSCLC) patients with T790M-positive tumors when first, or second-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment fails, but also for untreated advanced NSCLC patients with EGFR sensitizing mutation, so how to manage patients who get acquired resistance to osimertinib has becoming an emerging clinical challenge. This presentation would report a case of an advanced NSCLC patient with EGFR 19DEL who received combination therapy of toripalimab and chemotherapy after resistance to first line osimertinib therapy and achieved a PFS benefit of over 8 months. This case highlighted that immune checkpoint blockade combined chemotherapy might be a new possibility for advanced NSCLC patients with acquired resistance to osimertinib.
奥希替尼的临床活性和良好的毒性特征使其不仅被批准用于第一代或第二代表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗失败的T790M阳性肿瘤的晚期非小细胞肺癌(NSCLC)患者,还被批准用于未经治疗的具有EGFR敏感突变的晚期NSCLC患者,因此如何管理对奥希替尼产生获得性耐药的患者已成为一个新出现的临床挑战。本报告将介绍一例EGFR 19DEL的晚期NSCLC患者,该患者在一线奥希替尼治疗耐药后接受了托瑞帕利单抗和化疗的联合治疗,并获得了超过8个月的无进展生存期(PFS)获益。该病例突出表明,免疫检查点阻断联合化疗可能是对奥希替尼产生获得性耐药的晚期NSCLC患者的一种新选择。