PMID- 33708898
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210313
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 9
IP  - 3
DP  - 2021 Feb
TI  - Concealed driver in lung adenocarcinoma with single PIK3CA mutation: a case 
      report and single-center genotyping review.
PG  - 271
LID - 10.21037/atm-20-5948 [doi]
LID - 271
AB  - Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) 
      mutation has a prevalence of approximately 2% in lung adenocarcinoma. However, 
      cases presenting a PIK3CA mutation alone have rarely been reported, and the 
      clinical significance of a single PIK3CA mutation has not been well discussed. We 
      present 2 similar lung adenocarcinoma cases with a single PIK3CA alteration 
      initially but were found to have a concurrent epidermal growth factor receptor 
      (EGFR) mutation by another genotyping afterward. Both cases experienced an 
      excellent partial response after combination therapy of EGFR tyrosine kinase 
      inhibitor (EGFR-TKI) and angiogenesis inhibitor, which implies that the initial 
      absence of EGFR mutation was a false negative. A single-center retrospective 
      study among 2,214 cases of lung adenocarcinoma regarding their genotyping was 
      conducted. We found that the prevalence of PIK3CA mutation in lung adenocarcinoma 
      was 1.7%, 86.5% of which had other co-existing mutations, with EGFR mutation 
      being the most common. PIK3CA mutation tends to be concurrent with other 
      mutations in lung adenocarcinoma. Physicians should suspect a potential 
      false-negative driver mutation and promptly repeat genotyping when a single 
      PIK3CA mutation is reported in the genotyping of lung adenocarcinoma. 
      Furthermore, physicians should consider agents targeting the driver mutation 
      rather than agents targeting the phosphatidylinositol 
      3-kinase(PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway for treatment.
CI  - 2021 Annals of Translational Medicine. All rights reserved.
FAU - Zhu, Feng
AU  - Zhu F
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
FAU - Li, Jianfu
AU  - Li J
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
FAU - Li, Caichen
AU  - Li C
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
FAU - Xiong, Shan
AU  - Xiong S
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
FAU - Chen, Zhuxing
AU  - Chen Z
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
FAU - Cheng, Bo
AU  - Cheng B
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
FAU - Zhong, Ran
AU  - Zhong R
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
FAU - Liang, Wenhua
AU  - Liang W
AD  - China State Key Laboratory of Respiratory Disease and National Clinical Research 
      Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou 
      Medical University, Guangzhou, China.
LA  - eng
PT  - Case Reports
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC7940953
OTO - NOTNLM
OT  - PIK3CA
OT  - co-existing mutation
OT  - lung adenocarcinoma
OT  - molecular testing
OT  - targeted therapy
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/atm-20-5948). The authors have no 
      conflicts of interest to declare.
EDAT- 2021/03/13 06:00
MHDA- 2021/03/13 06:01
PMCR- 2021/02/01
CRDT- 2021/03/12 07:20
PHST- 2021/03/12 07:20 [entrez]
PHST- 2021/03/13 06:00 [pubmed]
PHST- 2021/03/13 06:01 [medline]
PHST- 2021/02/01 00:00 [pmc-release]
AID - atm-09-03-271 [pii]
AID - 10.21037/atm-20-5948 [doi]
PST - ppublish
SO  - Ann Transl Med. 2021 Feb;9(3):271. doi: 10.21037/atm-20-5948.