Osimertinib as neoadjuvant therapy in a patient with stage IIIA non-small cell lung cancer: a case report

Caroline Y Chen,Charlene M Fares,Daniel Sanghoon Shin

doi:10.1186/s13256-021-02748-y

Abstract

IntroductionTyrosine kinase inhibitors (TKI) targeting epidermal growth factor receptor (EGFR) are approved for use in metastatic non-small cell lung cancer (NSCLC).Case presentationHere we present a case of a African American patient with stage IIIA NSCLC treated with osimertinib in the neoadjuvant setting with concurrent radiation, followed by resection. The patient remains disease-free 4 months after surgery.ConclusionThis case report suggests that osimertinib may be effective as neoadjuvant therapy in resectable stage III disease. Additionally, we provide a summary of previous case reports and ongoing clinical trials for neoadjuvant EGFR inhibition in stage III NSCLC patients.

Highlights

Tyrosine kinase inhibitors (TKI) targeting epidermal growth factor receptor (EGFR) are approved for use in metastatic non-small cell lung cancer (NSCLC).Case presentation: Here we present a case of a African American patient with stage IIIA NSCLC treated with osimertinib in the neoadjuvant setting with concurrent radiation, followed by resection
The current US Food and Drug Administration (FDA)approved indications for osimertinib are as first-line therapy for EGFR mutation-positive advanced NSCLC or as second-line therapy in T790M mutation-positive advanced NSCLC patients that progress on a first-line TKI.[4]
Several case reports and small early-phase trials have described the use of TKIs in the neoadjuvant setting for stage III NSCLC with afatinib, erlotinib, and gefitinib.[5,6,7]

Summary

Conclusion

This is the first case report to show that osimertinib is effective in the neoadjuvant setting. Clinical trials are currently ongoing with neoadjuvant EGFR inhibitors for stage III NSCLC.

Introduction

Discussion