Lu Wenting, Sun Jiayi, Jing Yawan, Xu Jing, Huang Chengming, Deng Yi, Tian Panwen, Li Yalun
Department of Respiratory and Critical Care Medicine, Integrated Care Management Center, Institute of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Institute of Respiratory Health and Multimorbidity, Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, Precision Medicine Center/Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China.
Curr Oncol. 2025 Mar 28;32(4):201. doi: 10.3390/curroncol32040201.
Epidermal growth factor receptor () tyrosine kinase inhibitors (TKIs) are effective in non-small-cell lung cancer (NSCLC) with sensitizing mutations. However, patients with uncommon mutations show variable responses, and resistance often develops. The C797S mutation is a common resistance mechanism after third-generation -TKI osimertinib therapy, with no standard treatment established. A 37-year-old Chinese woman with advanced NSCLC harboring G719S/S768I mutations developed an acquired C797S mutation without T790M after second- and third-generation -TKI therapy. She was treated with a combination of gefitinib and bevacizumab, achieving a partial response, particularly in liver metastases. Her overall survival exceeded 60 months. Gefitinib combined with bevacizumab demonstrates efficacy in managing NSCLC with uncommon mutations and overcoming acquired C797S resistance. This combination therapy offers a promising treatment strategy for patients with limited options after resistance to second- and third-generation -TKIs.
表皮生长因子受体（）酪氨酸激酶抑制剂（TKIs）对具有敏感突变的非小细胞肺癌（NSCLC）有效。然而，具有罕见突变的患者表现出不同的反应，并且常常会产生耐药性。C797S突变是第三代-TKI奥希替尼治疗后的常见耐药机制，目前尚无标准治疗方案。一名37岁的中国晚期NSCLC女性患者，携带G719S/S768I突变，在接受第二代和第三代-TKI治疗后出现了获得性C797S突变且无T790M。她接受了吉非替尼和贝伐单抗联合治疗，取得了部分缓解，尤其是在肝转移方面。她的总生存期超过了60个月。吉非替尼联合贝伐单抗在治疗具有罕见突变的NSCLC和克服获得性C797S耐药方面显示出疗效。这种联合治疗为对第二代和第三代-TKIs耐药后选择有限的患者提供了一种有前景的治疗策略。
