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晚期非小细胞肺癌中表皮生长因子受体 L858R 与 S768I 复合突变:一例报告。

An epidermal growth factor receptor compound mutation of L858R with S768I in advanced non-small-cell lung cancer: a case report.

机构信息

Laboratory of Biomedical and Translational Research, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco.

Laboratory of Anatomic Pathology and Molecular Pathology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco.

出版信息

J Med Case Rep. 2024 Mar 18;18(1):118. doi: 10.1186/s13256-024-04422-5.

Abstract

BACKGROUND

In the current treatment landscape for non-small cell lung cancers, epidermal growth factor receptor-tyrosine kinase inhibitors have emerged as a well-established treatment option for patients with advanced or metastatic disease. This is particularly true for those with commonly occurring epidermal growth factor receptor mutations. However, the therapeutic efficacy of these agents for so-called rare epidermal growth factor receptor mutations, and in particular those characterized by a high degree of complexity, such as double mutations, remains a subject of clinical uncertainty.

CASE PRESENTATION

In this context, we present the case of a 64-year-old man of Moroccan descent, a lifelong non-smoker, diagnosed with metastatic non-small cell lung cancer characterized by a complex epidermal growth factor receptor mutation encompassing L858R and S768I. The patient subsequently underwent afatinib-based treatment, showing notable clinical results. These included a remarkable overall survival of 51 months, with a median progression-free survival of more than 39 months.

CONCLUSIONS

This case report is a compelling testimony to the evolving therapeutic landscape of non-small cell lung cancers, providing valuable insight into the potential therapeutic efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors in the realm of rare and complex epidermal growth factor receptor mutations.

摘要

背景

在非小细胞肺癌的当前治疗领域中,表皮生长因子受体酪氨酸激酶抑制剂已成为晚期或转移性疾病患者的一种成熟治疗选择。对于那些常见的表皮生长因子受体突变患者尤其如此。然而,这些药物对所谓的罕见表皮生长因子受体突变的治疗效果,特别是那些具有高度复杂性的突变,如双突变,仍然存在临床不确定性。

病例介绍

在这种情况下,我们介绍了一位 64 岁的摩洛哥裔男性患者的病例,他从不吸烟,被诊断患有转移性非小细胞肺癌,具有复杂的表皮生长因子受体突变,包括 L858R 和 S768I。随后,该患者接受了基于 afatinib 的治疗,取得了显著的临床效果。这些结果包括长达 51 个月的总生存期,中位无进展生存期超过 39 个月。

结论

本病例报告是对非小细胞肺癌治疗领域不断发展的有力证明,为表皮生长因子受体酪氨酸激酶抑制剂在罕见和复杂的表皮生长因子受体突变领域的潜在治疗效果提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57f7/10946199/f1ccd727d986/13256_2024_4422_Fig1_HTML.jpg

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