Overcoming Resistance to Osimertinib by T790M Loss and C797S Acquisition Using Gefitinib in a Patient With EGFR-Mutant NSCLC: A Case Report

Autor: Diego Enrico, MD, Florencia Tsou, MD, Greta Catani, MD, Carmen Pupareli, MD, María Romina Girotti, PhD, David Esteban Ulloa Alvarez, MD, Federico Waisberg, MD, Andrés Rodríguez, MD, Roxana Reyes, MD, Matías Chacón, MD, Noemí Reguart, MD, PhD, Claudio Martín, MD
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: JTO Clinical and Research Reports, Vol 4, Iss 2, Pp 100456- (2023)
Druh dokumentu: article
ISSN: 2666-3643
DOI: 10.1016/j.jtocrr.2022.100456
Popis: Limited strategies are available at disease progression on osimertinib for patients with EGFR-mutant NSCLC. The emergence of the on-target EGFR C797S mutation has been described as one of the most common mechanisms of resistance. In addition, loss of the EGFR T790M mutation has been mainly investigated as a resistance phenomenon to second-line osimertinib exposure. Remarkably, by studying the molecular profile at progression, it has been reported that the presence of the EGFR-sensitizing mutation, concurrently with the T790M, and C797S resulted in resistance to the current available EGFR tyrosine kinase inhibitors. Here, we report the first clinical evidence of gefitinib efficacy at EGFR exon 19 deletion/C797S mutation/T790M loss–mediated resistance to first-line osimertinib. Our findings highlight that dynamic genetic monitoring is a crucial approach in the evolution of EGFR-mutant NSCLC to understand the acquired molecular mechanisms for driving the best treatment strategy.
Databáze: Directory of Open Access Journals