Department of Medical Oncology, University Hospital of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC).
Department of Medicine, University of Udine.
Anticancer Drugs. 2022 Oct 1;33(9):960-962. doi: 10.1097/CAD.0000000000001321. Epub 2022 Aug 12.
Epidermal growth factor receptor (EGFR) G724S mutation represents a resistance mechanism to first- and third-generation EGFR tyrosine kinase inhibitors. Limited data are available regarding the efficacy of afatinib in patients with non-small cell lung cancer (NSCLC) harboring G724S mutation, particularly after osimertinib. A patient diagnosed with advanced EGFR-mutated (exon 19 deletion) NSCLC after several lines of treatment - gefitinib, osimertinib, heat shock protein inhibitors and chemotherapy-developed EGFR G724S mutation retaining the exon 19 deletion. She was then treated successfully with afatinib leading to a progression free survival of 9 months (and counting). This is the first report of the emergence of G724S mutation, together with ex19del, after three subsequent lines of therapy following progressive disease to Osimertinib, and we report for the first time the activity of afatinib against EGFR exon 18 G724S mutation in this setting.
表皮生长因子受体（EGFR）G724S 突变是对第一代和第三代 EGFR 酪氨酸激酶抑制剂产生耐药的机制之一。针对携带 G724S 突变的非小细胞肺癌（NSCLC）患者，奥希替尼治疗后，阿法替尼疗效的数据有限。一名患者在接受多线治疗（吉非替尼、奥希替尼、热休克蛋白抑制剂和化疗）后被诊断为晚期 EGFR 突变（外显子 19 缺失）非小细胞肺癌，之后出现保留外显子 19 缺失的 EGFR G724S 突变。随后，该患者成功接受阿法替尼治疗，无进展生存期为 9 个月（并持续中）。这是首例在奥希替尼治疗后出现疾病进展，经过三线治疗后同时出现 G724S 突变和外显子 19 缺失的报道，我们首次报道了阿法替尼在这种情况下针对 EGFR 外显子 18 G724S 突变的活性。
