PMID- 31183356
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2307-8960 (Print)
IS  - 2307-8960 (Electronic)
IS  - 2307-8960 (Linking)
VI  - 7
IP  - 10
DP  - 2019 May 26
TI  - Significant benefits of osimertinib in treating acquired resistance to 
      first-generation EGFR-TKIs in lung squamous cell cancer: A case report.
PG  - 1221-1229
LID - 10.12998/wjcc.v7.i10.1221 [doi]
AB  - BACKGROUND: Lung squamous cell cancer (LSCC) rarely harbors epidermal growth 
      factor receptor (EGFR) mutations, even much rarer for acquired T790M mutation. 
      Although clinical trials of AURA series illustrated that non-small cell lung 
      cancer (NSCLC) with EGFR T790M mutation can benefit from osimertinib, only five 
      LSCC patients were enrolled in total; moreover, the efficacy for LSCC was not 
      shown in the results. Therefore, the response of LSCC to osimertinib is still 
      unclear to date. CASE SUMMARY: We report an LSCC case with T790M-related acquired 
      resistance after treatments with first-generation EGFR-tyrosine kinase inhibitors 
      (EGFR-TKIs) and benefited from osimertinib significantly. A 63-year-old Chinese 
      man was diagnosed with stage IV (cT2N2M1b) LSCC harboring an EGFR exon 
      19-deletion mutation. Following disease progression after gefitinib and 
      multi-line chemotherapy, re-biopsy was conducted. Molecular testing of EGFR by 
      amplification refractory mutation system-polymerase chain reaction detected the 
      exon 19-deletion without T790M mutation. Therefore, the patient was given 
      erlotinib, but progression developed only 3 mo later. Then the frozen re-biopsy 
      tissue was tested by next-generation sequencing (NGS), which detected an EGFR 
      T790M mutation. However, he was very weak with symptoms of dysphagia and 
      cachexia. Fortunately, osimertinib was started, leading to alleviation from the 
      symptoms. Four months later, normal deglutition was restored and partial response 
      was achieved. Finally, the patient achieved an overall survival time period of 29 
      mo. CONCLUSION: Our findings highlight that EGFR T790M mutation may also be an 
      important acquired drug resistance mechanism for LSCC and offer direct evidence 
      of the efficacy of osimertinib in LSCC with T790M mutation. NGS and better 
      preservation conditions may contribute to higher sensitivity of EGFR T790M 
      detection.
FAU - Zhang, Yan
AU  - Zhang Y
AD  - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu 610041, Sichuan Province, China. zhang.yan@gmx.com.
FAU - Chen, Hui-Min
AU  - Chen HM
AD  - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu 610041, Sichuan Province, China.
FAU - Liu, Yong-Mei
AU  - Liu YM
AD  - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu 610041, Sichuan Province, China.
FAU - Peng, Feng
AU  - Peng F
AD  - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu 610041, Sichuan Province, China.
FAU - Yu, Min
AU  - Yu M
AD  - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu 610041, Sichuan Province, China.
FAU - Wang, Wei-Ya
AU  - Wang WY
AD  - Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, 
      Sichuan Province, China.
FAU - Xu, Heng
AU  - Xu H
AD  - Precision Medicine Center, State Key Laboratory of Biotherapy, Precision Medicine 
      Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, 
      Chengdu 610041, Sichuan Province, China.
FAU - Wang, Yong-Sheng
AU  - Wang YS
AD  - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu 610041, Sichuan Province, China.
FAU - Lu, You
AU  - Lu Y
AD  - Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan 
      University, Chengdu 610041, Sichuan Province, China.
LA  - eng
PT  - Case Reports
PL  - United States
TA  - World J Clin Cases
JT  - World journal of clinical cases
JID - 101618806
PMC - PMC6547322
OTO - NOTNLM
OT  - Case report
OT  - Epidermal growth factor receptor mutation
OT  - Lung cancer
OT  - Lung squamous cell cancer
OT  - Osimertinib
OT  - T790M
OT  - Targeted therapy
OT  - Tyrosine kinase inhibitor
COIS- Conflict-of-interest statement: The authors declare that they have no conflicts 
      of interest.
EDAT- 2019/06/12 06:00
MHDA- 2019/06/12 06:01
PMCR- 2019/05/26
CRDT- 2019/06/12 06:00
PHST- 2019/01/02 00:00 [received]
PHST- 2019/02/19 00:00 [revised]
PHST- 2019/03/16 00:00 [accepted]
PHST- 2019/06/12 06:00 [entrez]
PHST- 2019/06/12 06:00 [pubmed]
PHST- 2019/06/12 06:01 [medline]
PHST- 2019/05/26 00:00 [pmc-release]
AID - 10.12998/wjcc.v7.i10.1221 [doi]
PST - ppublish
SO  - World J Clin Cases. 2019 May 26;7(10):1221-1229. doi: 10.12998/wjcc.v7.i10.1221.