Efficacy of EGFR-TKI sequential therapy in patients with EGFR exon 19 insertion-positive non-small-cell lung cancer: A case report.

BACKGROUND: Insertions in exon 19 in the epidermal growth factor receptor gene (EGFR) is a rarely seen mutation in non-small cell lung cancer. These patients have been effectively treated with sequential EGFR tyrosine kinase inhibitors (TKIs). CASE SUMMARY: Here, we presented a case of non-small cell lung cancer, stage IIIB, with EGFR exon 19 insertion mutation as detected in the right lower lobe by next-generation sequencing. The patient was sequentially treated with first, second, and third-generation EGFR TKIs after the surgical operation. The overall survival of the patient was 21.3 mo. There was no dynamic analysis of drug resistance mechanisms in targeted therapy. CONCLUSION: This case emphasized the importance of following the guidelines. In patients with EGFR mutations, repeated and dynamic next-generation sequencing monitoring is necessary to prescribe a personalized treatment plan.

[The prevalence and risk factors of occupational asthma in workers exposed to isocyanate].

OBJECTIVE: To investigate the prevalence of occupational asthma, airway inflammation and analyze the risk factors for workers exposed to isocyanates. METHODS: A cross-sectional study was applied. Totally 429 isocyanates exposed workers were surveyed and the prevalence of occupational asthma and airway inflammation situation were examined by questionnaire, physical examination and laboratory tests. Multivariate logistic regression was applied to analyze the possible risk factors of isocyanate-induced occupational asthma. RESULTS: (1) A total of 366 patients with complete data were included in the study, and finally 11 cases were diagnosed as isocyanate-induced occupational asthma with a prevalence of 3.0%. (2) Neutrophil percentage in the induced sputum of occupational asthma increased significantly [42.00% (34.00%-55.00%) before work and 59.00% (51.00%-70.00%) after work (Z = -2.940. P < 0.05)]. (3) Length of service (OR = 3.096, P = 0.025) and rhinitis (OR = 1.901, P = 0.008) were independent dangerous factors, and protective measures (OR = 0.074, P = 0.015) was protective factors to isocyanate-induced occupational asthma. CONCLUSIONS: Neutrophilic inflammation can be triggered by isocyanate exposure. Regular health examinations, effective protective measures can reduce the prevalence of isocyanate-induced occupational asthma.