Wei Lingyun, Yang Nan, Gao Chuan, Li Weinan, Ye Mingxiang
Department of Cardiothoracic Surgery, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China.
Department of Respiratory Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China.
Respir Med Case Rep. 2024 Jul 15;51:102089. doi: 10.1016/j.rmcr.2024.102089. eCollection 2024.
Osimertinib is a third-generation tyrosine kinase inhibitor that targets mutant epidermal growth factor receptor (EGFR). The success of FLAURA and ADAURA trials prompted the license of Osimertinib for the treatment of EGFR mutant non-small cell lung cancer (NSCLC) at advanced stage and for patients with stages IB to IIIA disease in post-operative setting. In the present study, we described neoadjuvant use of Osimertinib in an EGFR mutant NSCLC patient with locally metastatic disease (T2aN2M0). Intriguingly, the cavitated NSCLC resembled an impressive"Halloween pumpkin" appearance that dramatically responded to Osimertinib treatment. Downstaging of N2 metastatic disease was reached and surgical resection was scheduled. The post-operative clinical stage was IA3. The patient was recommended to continue Osimertinib adjuvant treatment and our follow-ups showed no signs of disease recurrence. Our case study underscored the feasibility of Osimertinib as a neoadjuvant and adjuvant therapy for patients with locally advanced EGFR mutant NSCLC.
奥希替尼是一种靶向突变型表皮生长因子受体（EGFR）的第三代酪氨酸激酶抑制剂。FLAURA和ADAURA试验的成功促使奥希替尼获批用于治疗晚期EGFR突变型非小细胞肺癌（NSCLC）以及术后IB至IIIA期疾病的患者。在本研究中，我们描述了奥希替尼在一名患有局部转移性疾病（T2aN2M0）的EGFR突变型NSCLC患者中的新辅助治疗应用。有趣的是，空洞型NSCLC呈现出令人印象深刻的“万圣节南瓜”外观，对奥希替尼治疗有显著反应。N2转移性疾病实现了降期，并安排了手术切除。术后临床分期为IA3期。建议患者继续接受奥希替尼辅助治疗，我们的随访显示无疾病复发迹象。我们的病例研究强调了奥希替尼作为局部晚期EGFR突变型NSCLC患者新辅助和辅助治疗手段的可行性。
