Shan BB, Li Y, Zhao C, An XQ, Zhang QM. Efficacy of EGFR-TKI sequential therapy in patients with EGFR exon 19 insertion-positive non-small-cell lung cancer: A case report. World J Clin Cases 2022; 10(6): 1883-1888 [PMID: 35317151 DOI: 10.12998/wjcc.v10.i6.1883]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2022; 10(6): 1883-1888 Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1883
Efficacy of EGFR-TKI sequential therapy in patients with EGFR exon 19 insertion-positive non-small-cell lung cancer: A case report
Bin-Bin Shan, Yuan Li, Chang Zhao, Xiao-Qin An, Quan-Mao Zhang
Bin-Bin Shan, Yuan Li, Chang Zhao, Xiao-Qin An, Department of Pneumology, Shanxi Tumor Hospital, Taiyuan 030000, Shanxi Province, China
Quan-Mao Zhang, Endoscopy Center, Shanxi Tumor Hospital, Taiyuan 030000, Shanxi Province, China
Author contributions: Shan BB, Zhang QM, and Li Y conceived and designed the study; Zhao C analyzed the data; An XQ contributed to literature review; Zhang QM wrote the manuscript and reviewed and edited the manuscript; Shan BB and Li Y contributed equally to this study; all authors read and approved the final manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of the clinical data and any accompanying images. This is a retrospective case report and institutional approval was not needed.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: August 5, 2021 Peer-review started: August 5, 2021 First decision: November 6, 2021 Revised: November 12, 2021 Accepted: January 11, 2022 Article in press: January 11, 2022 Published online: February 26, 2022 Processing time: 202 Days and 6.6 Hours
Abstract
BACKGROUND
Insertions in exon 19 in the epidermal growth factor receptor gene (EGFR) is a rarely seen mutation in non-small cell lung cancer. These patients have been effectively treated with sequential EGFR tyrosine kinase inhibitors (TKIs).
CASE SUMMARY
Here, we presented a case of non-small cell lung cancer, stage IIIB, with EGFR exon 19 insertion mutation as detected in the right lower lobe by next-generation sequencing. The patient was sequentially treated with first, second, and third-generation EGFR TKIs after the surgical operation. The overall survival of the patient was 21.3 mo. There was no dynamic analysis of drug resistance mechanisms in targeted therapy.
CONCLUSION
This case emphasized the importance of following the guidelines. In patients with EGFR mutations, repeated and dynamic next-generation sequencing monitoring is necessary to prescribe a personalized treatment plan.
Core Tip: We presented a case of non-small cell lung cancer carrying the rare EGFR exon 19 insertion mutation. The patient had a good and durable response to afatinib, which provided clinical evidence for the use of afatinib in these patients.
