Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLC
Up to 20% of all non-small cell lung cancer patients harbor tumor specific driver mutations that are effectively treated with tyrosine kinase inhibitors. However, for the rare EGFR deletion-insertion mutation of exon 18, there is very little evidence regarding the effectiveness of tyrosine kinase in...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1182391/full |
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| author | Michael Cekay Philipp F. Arndt Philipp F. Arndt Rio Dumitrascu Rajkumar Savai Rajkumar Savai Rajkumar Savai Rajkumar Savai Andreas Braeuninger Stefan Gattenloehner Dagmar Steiner Fritz Roller Khodr Tello Katja Hattar Werner Seeger Ulf Sibelius Friedrich Grimminger Bastian Eul |
| author_facet | Michael Cekay Philipp F. Arndt Philipp F. Arndt Rio Dumitrascu Rajkumar Savai Rajkumar Savai Rajkumar Savai Rajkumar Savai Andreas Braeuninger Stefan Gattenloehner Dagmar Steiner Fritz Roller Khodr Tello Katja Hattar Werner Seeger Ulf Sibelius Friedrich Grimminger Bastian Eul |
| author_sort | Michael Cekay |
| collection | DOAJ |
| description | Up to 20% of all non-small cell lung cancer patients harbor tumor specific driver mutations that are effectively treated with tyrosine kinase inhibitors. However, for the rare EGFR deletion-insertion mutation of exon 18, there is very little evidence regarding the effectiveness of tyrosine kinase inhibitors. A particular challenge for clinicians in applying tyrosine kinase inhibitors is not only diagnosing a mutation but also interpreting rare mutations with unclear therapeutic significance. Thus, we present the case of a 65-year-old Caucasian male lung adenocarcinoma patient with an EGFR Exon 18 p.Glu709_Thr710delinsAsp mutation of uncertain therapeutic relevance. This patient initially received two cycles of standard platinum-based chemotherapy without any therapeutic response. After administration of Osimertinib as second line therapy, the patient showed a lasting partial remission for 12 months. Therapy related toxicities were limited to mild thrombocytopenia, which ceased after dose reduction of Osimertinib. To our knowledge, this is the first report of effective treatment of this particular mutation with Osimertinib. Hence, we would like to discuss Osimertinib as a viable treatment option in EGFR Exon 18 p.Glu709_Thr710delinsAsp mutated lung adenocarcinoma. |
| first_indexed | 2024-03-12T14:34:38Z |
| format | Article |
| id | doaj.art-c9b3ddacb6a3441c99d02d083bd1f2de |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-12T14:34:38Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-c9b3ddacb6a3441c99d02d083bd1f2de2023-08-17T12:07:09ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-08-011310.3389/fonc.2023.11823911182391Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLCMichael Cekay0Philipp F. Arndt1Philipp F. Arndt2Rio Dumitrascu3Rajkumar Savai4Rajkumar Savai5Rajkumar Savai6Rajkumar Savai7Andreas Braeuninger8Stefan Gattenloehner9Dagmar Steiner10Fritz Roller11Khodr Tello12Katja Hattar13Werner Seeger14Ulf Sibelius15Friedrich Grimminger16Bastian Eul17Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyMax Planck Institute for Heart and Lung Research, Member of the DZL, Member of CPI, Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyMax Planck Institute for Heart and Lung Research, Member of the DZL, Member of CPI, Giessen, GermanyInstitute for Lung Health (ILH), Justus Liebig University, Giessen, GermanyFrankfurt Cancer Institute (FCI), Goethe University, Frankfurt, GermanyDepartment of Pathology, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, GermanyDepartment of Pathology, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, GermanyDepartment of Nuclear Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, GermanyDepartment of Radiology, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyDepartment of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, GermanyUp to 20% of all non-small cell lung cancer patients harbor tumor specific driver mutations that are effectively treated with tyrosine kinase inhibitors. However, for the rare EGFR deletion-insertion mutation of exon 18, there is very little evidence regarding the effectiveness of tyrosine kinase inhibitors. A particular challenge for clinicians in applying tyrosine kinase inhibitors is not only diagnosing a mutation but also interpreting rare mutations with unclear therapeutic significance. Thus, we present the case of a 65-year-old Caucasian male lung adenocarcinoma patient with an EGFR Exon 18 p.Glu709_Thr710delinsAsp mutation of uncertain therapeutic relevance. This patient initially received two cycles of standard platinum-based chemotherapy without any therapeutic response. After administration of Osimertinib as second line therapy, the patient showed a lasting partial remission for 12 months. Therapy related toxicities were limited to mild thrombocytopenia, which ceased after dose reduction of Osimertinib. To our knowledge, this is the first report of effective treatment of this particular mutation with Osimertinib. Hence, we would like to discuss Osimertinib as a viable treatment option in EGFR Exon 18 p.Glu709_Thr710delinsAsp mutated lung adenocarcinoma.https://www.frontiersin.org/articles/10.3389/fonc.2023.1182391/fullnon-small cell lung cancerEGFR mutationtyrosine kinase inhibitors (TKIs)OsimertinibEGFR Exon 18 insertion |
| spellingShingle | Michael Cekay Philipp F. Arndt Philipp F. Arndt Rio Dumitrascu Rajkumar Savai Rajkumar Savai Rajkumar Savai Rajkumar Savai Andreas Braeuninger Stefan Gattenloehner Dagmar Steiner Fritz Roller Khodr Tello Katja Hattar Werner Seeger Ulf Sibelius Friedrich Grimminger Bastian Eul Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLC Frontiers in Oncology non-small cell lung cancer EGFR mutation tyrosine kinase inhibitors (TKIs) Osimertinib EGFR Exon 18 insertion |
| title | Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLC |
| title_full | Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLC |
| title_fullStr | Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLC |
| title_full_unstemmed | Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLC |
| title_short | Case Report: Durable therapy response to Osimertinib in rare EGFR Exon 18 mutated NSCLC |
| title_sort | case report durable therapy response to osimertinib in rare egfr exon 18 mutated nsclc |
| topic | non-small cell lung cancer EGFR mutation tyrosine kinase inhibitors (TKIs) Osimertinib EGFR Exon 18 insertion |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1182391/full |
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