[Biological diagnosis of resistance to erlotinib in a malignant pleural effusion]

Abstract

Introduction: The characterization of genetic abnormalities in non-small cell lung cancer (NSCLC) constitutes a theranostic revolution which is leading to rapid progress in the personalized management of this condition.

Case report: We present the case of a patient with NSCLC harboring an activating mutation of the Epidermal Growth Factor Receptor (EGFR). After two years of treatment with a tyrosine kinase inhibitor (TKI), the development of a pleural effusion demonstrated that the NSCLC had progressed. The T790M mutation was identified in tumour cells from the pleural aspirate. This anomaly had not been observed in the initial lung biopsy sample.

Conclusion: The genetic study of tumour cells contained in a biological fluid could be used to initiate molecular monitoring of the NSCLC tumour, without requiring repeated tissue biopsies and to customize the treatment in some patients with NSCLC.

Keywords: Cancer bronchique non à petites cellules; Drug resistance neoplasm; Epidermal growth factor receptor (EGFR); Inhibiteur tyrosine kinase; Malignant pleural effusion; Non-small cell lung cancer; Pleurésie métastatique; Récepteur du facteur de croissance épidermique (EGFR); Résistance aux anticancéreux; Tyrosine kinase inhibitor.