Medical Oncology Department, Hospital Universitario Central de Asturias, ISPA, Oviedo, Spain.
Anticancer Drugs. 2024 Aug 1;35(7):638-640. doi: 10.1097/CAD.0000000000001605. Epub 2024 Mar 15.
Mutations in tyrosine kinase domain of epidermal growth factor receptor (EGFR) are observed in approximately 15% of non-small cell lung cancer adenocarcinoma. Exon 19 deletions or exon 21 L858R mutations are predominant in frequency and show high sensitivity to EGFR tyrosine kinase inhibitors (TKIs). Exon 18 mutations are extremely rare and the delE709_T710insD mutation accounts for only 0.16% of mutations when occurring as a sole mutation. This specific mutation in exon 18 seems to respond to certain EGFR TKIs such as afatinib. However, given the rarity of this mutation, determining the most effective TKI for its treatment remains unclear. We report a 70-year-old woman diagnosed with stage IV-A lung adenocarcinoma harboring EGFR delE709_T710insD mutation treated in first-line with Osimertinib using standard schedule and doses experiencing renal toxicity and disease progression after 9 weeks of treatment.
表皮生长因子受体（EGFR）酪氨酸激酶结构域的突变在大约 15%的非小细胞肺癌腺癌中观察到。外显子 19 缺失或外显子 21 L858R 突变的频率较高，对 EGFR 酪氨酸激酶抑制剂（TKI）具有高敏感性。外显子 18 突变极为罕见，当单独发生时，delE709_T710insD 突变占突变的 0.16%。外显子 18 中的这种特定突变似乎对某些 EGFR TKI（如阿法替尼）有反应。然而，鉴于这种突变的罕见性，确定其治疗的最有效 TKI 仍不清楚。我们报告了一例 70 岁女性，诊断为 IV-A 期肺腺癌，携带 EGFR delE709_T710insD 突变，一线使用奥希替尼按标准方案和剂量治疗，在治疗 9 周后出现肾毒性和疾病进展。
