Zhu Yajie, Tang Jianning, Li Xin, Qin Tian, Wei Yang
Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610041, People's Republic of China.
Burning Rock Biotech, Guangzhou 510300, People's Republic of China.
Onco Targets Ther. 2020 Oct 14;13:10447-10451. doi: 10.2147/OTT.S268593. eCollection 2020.
Uncommon mutations account for 10-15% of epidermal growth factor receptor () mutations in patients with non-small-cell lung cancer (NSCLC). However, in spite of the wealth of knowledge of the clinical significance and tyrosine kinase inhibitor (TKI) sensitivity of these mutations, acquisition of deeper insights is limited by the paucity of case reports and cohort studies of the exceptionally rare mutations, including compound mutations. In the present case, we describe the clinical efficacy of icotinib and osimertinib in a metastatic lung adenocarcinoma patient carrying a highly uncommon L858R/D761Y compound mutation. The progression-free survival (PFS) with osimertinib treatment was much longer than that with icotinib (19 mo vs 8.2 mo), and the overall survival (OS) has currently exceeded three years. To the best of our knowledge, this is the first report of durable osimertinib response in an NSCLC patient with a rare L858R/D761Y mutation.
罕见突变占非小细胞肺癌（NSCLC）患者表皮生长因子受体（EGFR）突变的10%-15%。然而，尽管对这些突变的临床意义和酪氨酸激酶抑制剂（TKI）敏感性已有丰富认识，但由于包括复合突变在内的极其罕见突变的病例报告和队列研究匮乏，对其深入了解仍然有限。在本病例中，我们描述了埃克替尼和奥希替尼在一名携带高度罕见的L858R/D761Y复合突变的转移性肺腺癌患者中的临床疗效。奥希替尼治疗的无进展生存期（PFS）比埃克替尼长得多（19个月对8.2个月），总生存期（OS）目前已超过三年。据我们所知，这是首例关于奥希替尼对罕见L858R/D761Y突变的NSCLC患者产生持久反应的报告。
