Dacomitinib as a retreatment for advanced non-small cell lung cancer patient with an uncommon EGFR mutation.

Abstract

In non-small cell lung cancer (NSCLC), uncommon epidermal growth factor receptor (EGFR) mutations are mutations other than Ex19 deletion and Ex21 L858R, which are common mutations highly sensitive to EGFR-tyrosine kinase inhibitors. Afatinib, a second-generation EGFR-tyrosine kinase inhibitor, has been shown to be effective in patients with uncommon mutations. Dacomitinib, another second-generation EGFR-tyrosine kinase inhibitor, has not previously been shown to be effective in patients with uncommon mutations. Here, we report the efficacy of dacomitinib for uncommon EGFR mutations in a 71-year-old woman diagnosed with metastatic lung adenocarcinoma with uncommon EGFR mutation (Ex18 G719A). Afatinib was administered as the first-line treatment, and a remarkable antitumor effect was observed. However, the tumor grew after 14 months. Pemetrexed plus carboplatin followed by pemetrexed, docetaxel, atezolizumab and S-1 were performed in sequence. Although approximately four years had passed since the start of treatment, her physical condition was good. The patient started dacomitinib as the sixth-line treatment. Lesions were markedly reduced and treatment with dacomitinib was continued for 7.8 months. Dacomitinib is a possible treatment option for NSCLC with uncommon mutations.

• Authors: Ayako Morita, Shinobu Hosokawa, Kotaro Yamada, Takahiro Umeno, Hirohisa Kano, Hiroe Kayatani, Masaaki Shiojiri, Makoto Sakugawa, Akihiro Bessho
• Journal: Thoracic cancer (Thorac Cancer) Vol. 12 Issue 8 Pg. 1248-1251 (04 2021) ISSN: 1759-7714 [Electronic] Singapore
• PMID: 33651475 (Publication Type: Case Reports, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

Chemical References

• Quinazolinones
• dacomitinib
• EGFR protein, human
• ErbB Receptors

Topics

• Aged
• Carcinoma, Non-Small-Cell Lung (drug therapy, pathology)
• ErbB Receptors (metabolism)
• Female
• Humans
• Lung Neoplasms (drug therapy, pathology)
• Mutation
• Quinazolinones (pharmacology, therapeutic use)