A rare EGFR mutation L747P conferred therapeutic efficacy to both gefitinib and osimertinib: A case report

Lung Cancer. 2020 Dec:150:9-11. doi: 10.1016/j.lungcan.2020.09.017. Epub 2020 Sep 25.

Abstract

EGFR mutations, primarily sensitizing mutations such as exon 19 deletion and exon 21 point mutations, have been proven to act as predictive biomarkers for the response to tyrosine kinase inhibitors (TKIs). How patients harboring EGFR L747 P (a rare mutation located in exon 19) respond to EGFR-TKI is controversial. Some studies have described EGFR L747 P as providing intrinsic resistance to EGFR-TKIs, but others support this rare mutation as a sensitive mutation. Hence, we reported a patient with advanced lung adenocarcinoma harboring an EGFR L747 P who benefited from first-line treatment with gefitinib. This patient achieved stable disease (SD) and had a progression-free survival (PFS) of 18 months. After disease progression, this patient was subsequently administered osimertinib and responded, as evidenced by a significant reduction in nodular lesions. This case revealed that EGFR L747 P rendered both gefitinib and osimertinib therapeutically efficacious.

Keywords: EGFR L747P; EGFR tyrosine kinase inhibitors; Lung cancer; Next-generation sequencing.

Publication types

  • Case Reports

MeSH terms

  • Acrylamides
  • Aniline Compounds
  • ErbB Receptors* / genetics
  • Gefitinib / therapeutic use
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Mutation
  • Protein Kinase Inhibitors / therapeutic use

Substances

  • Acrylamides
  • Aniline Compounds
  • Protein Kinase Inhibitors
  • osimertinib
  • EGFR protein, human
  • ErbB Receptors
  • Gefitinib