一名携带新型外显子20插入突变的非小细胞肺癌患者对阿法替尼的反应
Response to Afatinib in a Patient with NSCLC Harboring Novel Exon 20 Insertion Mutations.
作者信息
Lin Ling, Wu Xiaomai, Yan Shuangquan, Zhu Yefei, Yan Zhengqing, Lv Dongqing, Ge Hongfei
机构信息
Department of Respiratory Medicine, Taizhou Hospital of Wenzhou Medical University, Taizhou, People's Republic of China.
The Medical Department, 3D Medicines Inc., Shanghai, People's Republic of China.
出版信息
Onco Targets Ther. 2020 Sep 30;13:9753-9757. doi: 10.2147/OTT.S268694. eCollection 2020.
PURPOSE
Most epidermal growth factor receptor (EGFR) exon 20 insertion (ex20ins) mutations are resistant to tyrosine kinase inhibitors (TKIs). While some non-small cell lung cancer (NSCLC) patients harboring special subtypes of ex20ins still achieved clinical response after TKIs treatment, identifying special subtypes of ex20ins is helpful to find out NSCLC patients who can respond to TKIs.
CASE PRESENTATION
A 71-year-old non-smoker Chinese female was diagnosed with advanced lung adenocarcinoma harboring ex20ins (N771delinsKG). The patient received first-line afatinib (40 mg/day) therapy and a significant and substantial reduction in tumor size was observed subsequently. According to RESIST 1.1, a radiological partial response was achieved. The final progression-free survival was 10 months.
CONCLUSION
This is the first published case report of N771delinsKG lung adenocarcinoma, which highlighted the heterogeneity of clinical response to TKIs for ex20ins-mutant NSCLC. Such results need to be further investigated in prospective studies.
目的
大多数表皮生长因子受体（EGFR）外显子20插入（ex20ins）突变对酪氨酸激酶抑制剂（TKIs）耐药。虽然一些携带特殊亚型ex20ins的非小细胞肺癌（NSCLC）患者在TKIs治疗后仍取得了临床反应，但识别ex20ins的特殊亚型有助于找出对TKIs有反应的NSCLC患者。
病例介绍
一名71岁不吸烟的中国女性被诊断为患有携带ex20ins（N771delinsKG）的晚期肺腺癌。患者接受一线阿法替尼（40毫克/天）治疗，随后观察到肿瘤大小显著且大幅缩小。根据RESIST 1.1标准，达到了放射学部分缓解。最终无进展生存期为10个月。
结论
这是首次发表的关于N771delinsKG肺腺癌的病例报告，突出了ex20ins突变的NSCLC对TKIs临床反应的异质性。此类结果需要在前瞻性研究中进一步探究。
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