Kian Waleed, Krayim Bilal, Alsana Hadel, Giles Betsy, Purim Ofer, Alguayn Wafeek, Alguayn Farouq, Peled Nir, Roisman Laila C
The Oncology Institute, Shaare Zedek Medical Center, Jerusalem, Israel.
Pulmonology Department, Soroka Medical Center & Ben-Gurion University, Beer-Sheva, Israel.
Front Oncol. 2023 Feb 27;13:1124949. doi: 10.3389/fonc.2023.1124949. eCollection 2023.
Lung cancer is the most common cancer-related cause of death worldwide, most of which are non-small cell lung cancers (NSCLC). Epidermal growth factor receptor (EGFR) mutations are common drivers of NSCLC. Treatment plans for NSCLC, specifically adenocarcinomas, rely heavily on the presence or absence of specific actionable driver mutations. Liquid biopsy can guide the treatment protocol to detect the presence of various mechanisms of resistance to treatment. We report three NSCLC EGFR mutated cases, each treated with Osimertinib in a combination therapy regimen to combat resistance mechanisms. The first patient presented with EGFR L858R/L833V compound mutation with MET amplification alongside CEP85L-ROS1 fusion gene, the second with EGFR exon 19del and MKRN1-BRAF fusion, and the last EGFR L858R/V834L compound mutation with MET amplification. Each regimen utilized a tyrosine kinase inhibitor or monoclonal antibody in addition to osimertinib and allowed for a prompt and relatively durable treatment response.
肺癌是全球与癌症相关的最常见死因，其中大多数是非小细胞肺癌（NSCLC）。表皮生长因子受体（EGFR）突变是NSCLC的常见驱动因素。NSCLC（特别是腺癌）的治疗方案在很大程度上依赖于特定可操作驱动突变的存在与否。液体活检可以指导治疗方案，以检测对治疗的各种耐药机制的存在情况。我们报告了三例NSCLC EGFR突变病例，每例均采用奥希替尼联合治疗方案来对抗耐药机制。第一例患者出现EGFR L858R/L833V复合突变，伴有MET扩增以及CEP85L-ROS1融合基因；第二例患者为EGFR外显子19缺失和MKRN1-BRAF融合；最后一例患者为EGFR L858R/V834L复合突变，伴有MET扩增。每个治疗方案除奥希替尼外还使用了酪氨酸激酶抑制剂或单克隆抗体，并实现了迅速且相对持久的治疗反应。
