Department of Oncology.
Outpatient Department, General Hospital of Northern Theater Command, Shenyang, China.
Anticancer Drugs. 2024 Sep 1;35(8):764-768. doi: 10.1097/CAD.0000000000001624. Epub 2024 Jul 16.
Based on the FLAURA and AURA III trials, compared to first- and second-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs), osimertinib provides a longer overall survival benefit for patients with untreated EGFR mutated non-small cell lung cancer. Similar to other EGFR-TKIs, drug resistance is, however, inevitable. The most common mechanism of acquired resistance to first-line osimertinib therapy is the C797S mutation, which accounts for 6% of cases. In view of the current challenges of the development of the next generation of EGFR inhibitors, the mechanism of third-generation targeted drug resistances and targeted strategies are key for further exploration. Our case report discusses a female patient with advanced lung adenocarcinoma carrying the EGFR exon19 E746_A750delinsIP mutation who received osimertinib as first-line therapy and acquired C797S resistance during treatment. The patient was then treated with icotinib for 8 months until the disease progressed. Icotinib may be effective in patients with the EGFR 19del-C797S resistant mutation acquired after osimertinib treatment.
基于 FLAURA 和 AURA III 试验，与第一代和第二代表皮生长因子受体 (EGFR)-酪氨酸激酶抑制剂 (TKI) 相比，奥希替尼为未经治疗的 EGFR 突变型非小细胞肺癌患者提供了更长的总生存期获益。与其他 EGFR-TKI 类似，耐药性是不可避免的。一线奥希替尼治疗获得性耐药最常见的机制是 C797S 突变，占 6%。鉴于下一代 EGFR 抑制剂发展面临的当前挑战，第三代靶向药物耐药机制和靶向策略是进一步探索的关键。我们的病例报告讨论了一名携带 EGFR 外显子 19 E746_A750delinsIP 突变的晚期肺腺癌女性患者，该患者接受奥希替尼作为一线治疗，并在治疗过程中发生 C797S 耐药。随后，该患者接受厄洛替尼治疗 8 个月，直至疾病进展。厄洛替尼可能对奥希替尼治疗后获得的 EGFR 19del-C797S 耐药突变患者有效。
