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阿美替尼与吡咯替尼联合治疗EGFR突变/HER2扩增的晚期非小细胞肺癌患者实现长期生存:一例报告及文献复习

Long term survival achieved through combination of almonertinib and pyrotinib in EGFR-mutant/HER2-amplified advanced NSCLC patient: a case report and literature review.

作者信息

Pan Xin, Zhou Xiao

机构信息

Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.

出版信息

Front Oncol. 2024 Aug 9;14:1397238. doi: 10.3389/fonc.2024.1397238. eCollection 2024.

DOI:10.3389/fonc.2024.1397238
PMID:39184039
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11341367/
Abstract

BACKGROUD

Human epithelial growth factor receptor 2 (HER2) amplification is an important mechanism of acquired resistance to anti-epidermal growth factor receptor (EGFR) therapy in non-small cell lung cancer (NSCLC) patients. For patients with both EGFR mutation and HER2 amplification, there is currently no unified standard treatment, and further exploration is needed on how to choose the therapy.

METHODS AND RESULTS

A female NSCLC patient developed bone and brain metastases 14 and 42 months after radical surgery, respectively. The second genetic sequencing detected EGFR L858R mutation and HER2 amplification, and therefore initiated treatment with almonertinib and pyrotinib. The patient achieved partial remission and did not show any further progression during the follow-up period.

CONCLUSION

For NSCLC patients with both EGFR mutation and HER2 amplification, the combination of almonertinib and pyrotinib is a valuable therapy that can continuously reduce tumor burden and achieve long-term survival.

摘要

背景

人表皮生长因子受体2(HER2)扩增是非小细胞肺癌(NSCLC)患者获得性抗表皮生长因子受体(EGFR)治疗耐药的重要机制。对于同时存在EGFR突变和HER2扩增的患者,目前尚无统一的标准治疗方案,如何选择治疗方法仍需进一步探索。

方法与结果

一名女性NSCLC患者在根治性手术后分别于14个月和42个月出现骨转移和脑转移。第二次基因测序检测到EGFR L858R突变和HER2扩增,因此开始使用阿美替尼和吡咯替尼治疗。患者达到部分缓解,随访期间未出现任何进一步进展。

结论

对于同时存在EGFR突变和HER2扩增的NSCLC患者,阿美替尼和吡咯替尼联合治疗是一种有价值的治疗方法,可持续减轻肿瘤负担并实现长期生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/37f10da2ac95/fonc-14-1397238-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/f89abb23f4dd/fonc-14-1397238-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/6551dc933717/fonc-14-1397238-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/b0d262c18056/fonc-14-1397238-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/37f10da2ac95/fonc-14-1397238-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/f89abb23f4dd/fonc-14-1397238-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/6551dc933717/fonc-14-1397238-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/b0d262c18056/fonc-14-1397238-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fbc/11341367/37f10da2ac95/fonc-14-1397238-g004.jpg

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本文引用的文献

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Efficacy and safety of a pyrotinib-based regimen in non-small cell lung cancer patients harboring HER2 alterations: A real-world retrospective study.吡咯替尼方案治疗携有 HER2 改变的非小细胞肺癌患者的疗效和安全性:一项真实世界回顾性研究。
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Trastuzumab Deruxtecan in Patients With -Mutant Metastatic Non-Small-Cell Lung Cancer: Primary Results From the Randomized, Phase II DESTINY-Lung02 Trial.曲妥珠单抗-德曲妥珠单抗用于 - 突变型转移性非小细胞肺癌患者:来自随机、II 期 DESTINY-Lung02 试验的主要结果。
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First-line pyrotinib in advanced HER2-mutant non-small-cell lung cancer: a patient-centric phase 2 trial.一线吡咯替尼治疗晚期 HER2 突变型非小细胞肺癌:一项以患者为中心的 2 期临床试验。
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