OSIMERTINIB COUPLED WITH ERLOTINIB ALLEVIATED ACQUIRED RESISTANCE TO EGFR-TKIS MONOTHERAPY IN A PATIENT WITH EGFR P. GLU746_ALA750 DEL (E19)-MUTANT NSCLC: A CASE REPORT

Abstract

TYPE: Abstract Publication TOPIC: Lung Cancer PURPOSE: EGFR-mutant NSCLC patients receive epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) therapy as First-line therapy globally. EGFR-TKIs acquired resistance is the major reason for the failure of treatment regimen. The case we present here is an advanced NSCLC Chinese male patient with acquired EGFR p. Glu746_Ala750 del (E19) mutation responses to erlotinib after third EGFR-TKIs. METHODS: not applicable RESULTS: case report A 65-year old Chinese male patient with main complaint of dry cough was diagnosed with non-small cell lung adenocarcinoma with clinical staging of T4N3M1, stage IV (with pleural and bone metastasis) in January 2017. The patient accepted first-line treatment of Erlotinib according to his gene status of an EGFR exon 19 deletion mutation by tumor biopsy. After 24 months of progression-free survival, he experienced progressive disease and switched to the third-line treatment of Osimertinib with the emergence of EGFR T790M by plasm. Four months later, the patient relapsed again with brain metastasis and EGFR p. Glu746_Ala750 del (E19) mutation was detected. Regarding of acquired resistance to first-generation TKIs and third-generation TKIs he got, the patient was set in a combination of Osimertinib and Erlotinib. After one month, the patient got dramatical clinical benefit from the combined treatment being evaluated as PR. CONCLUSIONS: Not Applicable CLINICAL IMPLICATIONS: when advanced NSCLC patients with acquired EGFR p. Glu746_Ala750 del (E19) mutation after third EGFR-TKIs resistant the combination of third TKIs and erlotinib may be effective. DISCLOSURE: No significant relationships. KEYWORDS: osimertinib, nsclc, EGFR-TKIs resistance