Zhao Yuanyang, Chen Yuxing, Huang Huaying, Li Xi, Shao Lin, Ding Hao
Department of Respiratory Disease, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212002, People's Republic of China.
Department of Medicine, Burning Rock Biotech, Guangzhou, 510300, People's Republic of China.
Onco Targets Ther. 2021 May 7;14:3063-3067. doi: 10.2147/OTT.S300556. eCollection 2021.
EGFR-tyrosine kinase inhibitors (TKIs) have revolutionized the treatment for NSCLC. However, acquired drug resistance often occurs after treatment with EGFR-TKIs. T790M and C797S mutations are the most common resistance mechanism in patients who failed from first- and third- generation EGFR TKI treatments, respectively. However, there is no standard of care for NSCLC harboring T790M and C797S in-cis. The present case reports a 69-year-old Chinese man with advanced NSCLC harboring exon 19-deletion, T790M, cis-C797S, and amplification who was heavily pre-treated. The patient was then given a combination of afatinib and apatinib and achieved a PFS of more than 10 months. This case showed that afatinib plus apatinib may be a promising therapy for patients with 19Del-T790M-cis-C797S mutant and amplified NSCLC.
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）彻底改变了非小细胞肺癌（NSCLC）的治疗方式。然而，使用EGFR-TKIs治疗后常常会出现获得性耐药。T790M和C797S突变分别是第一代和第三代EGFR-TKI治疗失败患者中最常见的耐药机制。然而，对于存在顺式T790M和C797S的NSCLC患者，尚无标准治疗方案。本病例报告了一名69岁的中国男性晚期NSCLC患者，该患者存在外显子19缺失、T790M、顺式C797S以及扩增，且接受过大量前期治疗。随后该患者接受了阿法替尼和阿帕替尼联合治疗，无进展生存期（PFS）超过10个月。该病例表明，阿法替尼加阿帕替尼可能是治疗具有19Del-T790M-顺式C797S突变及扩增的NSCLC患者的一种有前景的治疗方法。
