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- W3135954112 abstract "Epidermal growth factor receptor (EGFR) exon 20 insertion mutations have been identified in approximately 4% of non-small cell lung cancer (NSCLC) cases. Many previous works suggested that EGFR exon 20 insertion mutations were generally associated with insensitivity to available tyrosine kinase inhibitors (TKIs). Currently, no standard targeted therapies are approved for NSCLC patients harboring EGFR exon 20 insertion mutations. Next-generation sequencing (NGS) on the tumor tissue was performed. A 71-year-old non-smoker Chinese female was diagnosed with lung adenocarcinoma with multiple metastases in bilateral lung and mass in the right chest with osteolytic bone destruction in the sixth rib in May 2019. The tumor node metastasis (TNM) classification of this patient was T4N3M1. Before treatment, her tumor DNA extracted from tissue was subjected to DNA sequencing analysis using a cancer-gene panel (3D Medicines, Shanghai, China) with next-generation sequencing (NGS). The sequencing results suggested that the patient had a novel EGFR exon 20 insertion mutation (EGFR p. N771delinsKG). The patient started to receive first-line treatment with afatinib (40 mg/day) according to the NGS results in July 2019. Before the treatment, the computed tomography (CT) scans showed that the size of tumor lesions located in left lower lung and right chest were 62.6 mm×60.9 mm and 58.3 mm×46.7 mm respectively. After the treatment of afatinib, one lesion in left lower lung became obscure and unmeasurable, and the tumor size of the other lesion in right chest decreased to 43.7 mm×37.2 mm. According to the response evaluation criteria in solid tumors (RESIST 1.1), she achieved a radiological partial response (PR). Furthermore, no grade 3 or higher adverse events (AEs) occurred. The treatment-related AEs associated with afatinib were grade 1 or 2 diarrhea, skin rash, paronychia and stomatitis without treatment interruption. These AEs occurred during the first month of afatinib treatment and relieved with corresponding symptomatic treatments. Until May 2020, progressive disease was observed due to the enlarged tumor lesions. The final PFS was 10 months. Overall, we reported the first case of a patient with NSCLC harboring a novel EGFR exon 20 insertion mutation (p. N771delinsKG), who benefited from afatinib. Based on this finding, afatinib might be considered as an optimal treatment for NSCLC harboring uncommon EGFR exon 20 insertion mutations. Further investigations need to be carried out." @default.
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- W3135954112 date "2021-03-01" @default.
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- W3135954112 title "P76.99 Response to Afatinib in a Patient with NSCLC Harboring Novel EGFR Exon 20 Insertion Mutations" @default.
- W3135954112 doi "https://doi.org/10.1016/j.jtho.2021.01.1156" @default.
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