Dacomitinib overcomes acquired resistance to osimertinib in advanced NSCLC patients with EGFR L718Q mutation: A two-case report.
Medicine (Baltimore)
; 103(28): e38789, 2024 Jul 12.
Article
in En
| MEDLINE
| ID: mdl-38996163
ABSTRACT
RATIONALE Acquired resistance still inevitably occurs in patients treated with third-generation TKI osimertinib. Although the EGFR L718Q mutation has been reported as a scarce mechanism of osimertinib resistance, advanced therapeutic strategies are still in development. In this report, we included 2 cases of patients who acquired EGFR L858R/L718Q mutation after osimertinib and were overcome by dacomitinib. PATIENT CONCERNS Case 1 A 77-year-old woman was diagnosed with stage IV lung adenocarcinoma. Case 2 A 64-year-old woman was diagnosed with stage IV lung adenocarcinoma. DIAGNOSES Case 1 The patient was diagnosed with adenocarcinoma with EGFR L858R mutation. Since then, treatment with gefitinib was administrated, leading to a progression-free survival of 18 months. The treatment was switched to osimertinib based on the detection of EGFR T790M mutation, resulting in a progression-free survival of 24 months. Subsequently, EGFR L718Q mutation was detected. Case 2 The patient was diagnosed with adenocarcinoma with EGFR L858R mutation. Icotinib was used as the first-line treatment for 7 months. Osimertinib was applied as the second-line treatment for 13 months based on the EGFR T790M mutation. Subsequently, EGFR L718Q mutation was detected. INTERVENTIONS:
Case 1 Dacomitinib was administered. Case 2 Dacomitinib was administered.OUTCOMES:
Case 1The progression-free survival was 8 months. Case 2 The progression-free survival was 3 months. LESSONS Dacomitinib is a potential treatment option for NSCLC patients with EGFR L718Q mutation after resistance to Osimertinib. Further research is needed to validate the efficacy of Dacomitinib in this context.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Acrylamides
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Carcinoma, Non-Small-Cell Lung
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Drug Resistance, Neoplasm
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Quinazolinones
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ErbB Receptors
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Aniline Compounds
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Lung Neoplasms
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Mutation
Limits:
Aged
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Female
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Humans
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Middle aged
Language:
En
Journal:
Medicine (Baltimore)
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: