Re-biopsy after relapse of targeted therapy. T790M after epidermal growth factor mutation, where and why based on a case series

Paul Zarogoulidis; Aggeliki Rapti; Chrysanthi Sardeli; Panagiotis Chinelis; Anastasia Athanasiadou; Katerina Paraskevaidou; Anastasios Kallianos; Lemonia Veletza; Georgia Trakada; Wolfgang Hohenforst-Schmidt; Haidong Huang

doi:10.1016/j.rmcr.2017.05.013

Re-biopsy after relapse of targeted therapy. T790M after epidermal growth factor mutation, where and why based on a case series

Respir Med Case Rep. 2017 May 30:21:171-175. doi: 10.1016/j.rmcr.2017.05.013. eCollection 2017.

Affiliations

¹ Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
² Second Pulmonary Clinic, 'Sotiria' Chest Diseases Hospital, Athens, Greece.
³ Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁴ Division of Pulmonology, Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Alexandra Hospital, Athens, Greece.
⁵ Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, "Hof" Clinics, University of Erlangen, Hof, Germany.
⁶ Department of Respiratory and Critical Care Medicine, Changhai Hospital/First Affiliated Hospital of the Secondary Military Medical University, Shanghai, China.

Abstract

Guidelines for the treatment of non-small cell lung cancer adenocarcinoma positive in epidermal growth factor mutations indicate tyrosine kinase inhibitors. There are currently three tyrosine kinase inhibitors that can be used as first line treatment: gefitinib, erlotinib and afatinib. Regarding erlotinib and afatinib dosage can be modified in the case of severe adverse effects. In the case of disease relapse investigation for T790M mutation has to be made either with re-biopsy or liquid biopsy and osimertinib has to be administered when T790M is diagnosed. Based on a case series we indicate which is the best approach for T790M mutation.

Keywords: Adenocarcinoma; Erlotinib and afatinib; Gefitinb; NSCLC.

Publication types

Case Reports