Department of Pulmonary Medicine, Mie Chuo Medical Center, Tsu, Japan.
Department of Pulmonary and Critical Care Medicine, Mie University Faculty and Graduate School of Medicine, Tsu, Japan.
Thorac Cancer. 2023 Mar;14(7):709-713. doi: 10.1111/1759-7714.14807. Epub 2023 Jan 29.
Epidermal growth factor receptor (EGFR)-mutated squamous cell carcinoma (SCC) is less common than adenocarcinoma. The third-generation EGFR-tyrosine kinase inhibitor, osimertinib, is effective in EGFR-mutated lung adenocarcinoma, but its efficacy in EGFR-mutated lung SCC is unclear. The patient was an 83-year-old male. He was diagnosed with SCC of the lung, and molecular analysis revealed that the tumor was positive for EGFR exon19 deletion. He was treated with osimertinib 80 mg/day. No adverse events were observed, but after 18 days of therapy, he complained of dyspnea, and a computed tomography scan showed enlarged lung cancer. The case was categorized as a progressive disease. The patient died 3 weeks later. The autopsy findings confirmed the diagnosis of lung SCC, with morphology and immunohistochemical staining identical to the tumor obtained by bronchoscopy. Next-generation sequencing showed the presence of TP53 R158L, CDK6, and KRAS amplifications. The current case report shows that next-generation sequencing can explain why osimertinib is ineffective in EGFR-mutated SCC.
表皮生长因子受体（EGFR）突变型鳞状细胞癌（SCC）比腺癌少见。第三代 EGFR 酪氨酸激酶抑制剂奥希替尼对 EGFR 突变型肺腺癌有效，但对 EGFR 突变型肺 SCC 的疗效尚不清楚。该患者为 83 岁男性，诊断为 SCC 肺癌，分子分析显示肿瘤 EGFR 外显子 19 缺失阳性。他接受了奥希替尼 80mg/天的治疗。未观察到不良反应，但在治疗 18 天后，他出现呼吸困难，CT 扫描显示肺癌增大。该病例被归类为进展性疾病。患者 3 周后死亡。尸检结果证实了肺 SCC 的诊断，其形态和免疫组织化学染色与支气管镜获得的肿瘤相同。下一代测序显示存在 TP53 R158L、CDK6 和 KRAS 扩增。本病例报告表明，下一代测序可以解释为什么奥希替尼对 EGFR 突变型 SCC 无效。
