Ren Fei, Wang Yao, Gao Yongsheng, Meng Xiangjiao
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Department of Pathology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
Front Oncol. 2022 Aug 30;12:971192. doi: 10.3389/fonc.2022.971192. eCollection 2022.
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) have been widely used in the treatment of locally advanced non-small cell lung cancer (NSCLC). The phenomenon of pseudoprogression in targeted therapy in EGFR-mutation NSCLC patients is rare. Here, we reported an EGFR-mutation-positive lung adenocarcinoma patient who was admitted to a hospital for cough and chest distress accompanied by shortness of breath. He underwent four cycles of chemotherapy with pemetrexed combined with carboplatin and concurrent radiotherapy in the third and fourth cycles. Then, he was treated by osimertinib maintenance therapy. After 11.5 months of osimertinib treatment, he was assessed to progressive disease by computed tomography. He underwent fiber bronchoscopy, and the biopsy pathology showed extensive necrosis without tumor cells. Until now, the patient has continued on osimertinib for 7 months without relapse or metastasis. As far as we know, we are the first to report pseudoprogression in osimertinib maintenance after definitive chemoradiation. This study reminds the clinicians to distinguish pseudoprogression from osimertinib-induced progression and avoid abandoning effective treatments.
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）已广泛应用于局部晚期非小细胞肺癌（NSCLC）的治疗。EGFR突变的NSCLC患者在靶向治疗中出现假性进展的现象较为罕见。在此，我们报告1例EGFR突变阳性的肺腺癌患者，因咳嗽、胸闷伴气短入院。他接受了4个周期培美曲塞联合卡铂化疗，在第3和第4周期同时接受放疗。然后，他接受奥希替尼维持治疗。奥希替尼治疗11.5个月后，计算机断层扫描评估为疾病进展。他接受了纤维支气管镜检查，活检病理显示广泛坏死，无肿瘤细胞。截至目前，该患者继续服用奥希替尼7个月，无复发或转移。据我们所知，我们是首个报道在确定性放化疗后奥希替尼维持治疗中出现假性进展的。本研究提醒临床医生要区分假性进展与奥希替尼诱导的进展，避免放弃有效的治疗。
