Department of Thoracic Surgery, Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Anticancer Drugs. 2023 Sep 1;34(8):939-941. doi: 10.1097/CAD.0000000000001523. Epub 2023 Apr 28.
Although uncommon epidermal growth factor receptor (EGFR) mutations account for 10-15% EGFR mutant non-small cell lung cancer (NSCLC) patients, clinical evidence for uncommon EGFR mutations, such as complex mutations remain limited. In this study, we reported a NSCLC patient harboring complex EGFR L833V / H835L mutation in exon 21, who had a complete response to first-line osimertinib monotherapy. The patient admitted to our hospital for space-occupying lesions of right lower lung during an annual health checkup, and was diagnosed as stage IIIA lung adenocarcinoma. Targeted next-generation sequencing (NGS) on tumor samples showed a complex EGFR mutation: L833V / H835L in exon 21. Therefore, she was treated with osimertinib monotherapy and complete remission achieved soon. During follow-up period, no metastasis was found and serum carcinoembryonic antigen returned to normal. In addition, NGS monitoring of mutations in circulating tumor DNA maintained negative. The patient remain benefitted for osimertinib monotherapy over 22 months with no disease progression. Our case firstly provided clinical evidences of first-line osimertinib therapy in lung cancer patients with rare L833V / H835L EGFR mutation.
虽然罕见的表皮生长因子受体 (EGFR) 突变占 EGFR 突变型非小细胞肺癌 (NSCLC) 患者的 10-15%，但罕见 EGFR 突变（如复杂突变）的临床证据仍然有限。在本研究中，我们报告了一例 NSCLC 患者携带外显子 21 上的复杂 EGFR L833V / H835L 突变，该患者对一线奥希替尼单药治疗有完全反应。该患者在年度体检时因右下肺占位性病变入住我院，并被诊断为 IIIA 期肺腺癌。肿瘤样本的靶向下一代测序 (NGS) 显示出复杂的 EGFR 突变：外显子 21 上的 L833V / H835L。因此，她接受奥希替尼单药治疗，很快就达到了完全缓解。随访期间，未发现转移，血清癌胚抗原恢复正常。此外，循环肿瘤 DNA 中突变的 NGS 监测保持阴性。患者在无疾病进展的情况下继续接受奥希替尼单药治疗超过 22 个月，从中获益。我们的病例首次提供了罕见的 L833V / H835L EGFR 突变肺癌患者一线奥希替尼治疗的临床证据。
