EGFR exon 18 delE709_T710insD mutated stage IV lung adenocarcinoma with response to afatinib

Ibrahim, Uroosa; Saqib, Amina; Atallah, Jean Paul

doi:10.1016/j.lungcan.2017.02.023

Cited by 21 publications

(18 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shen et al showed that G779F, L747P, and M825L with R831C were sensitizing mutations, whereas V717G, I715V, K716E, and complex non-classic mutation, such as V742F, A743V, and H773R, were resistant mutations [ 9 ]. Ibrahim et al reported a patient with stage IV lung adenocarcinoma harboring delE709 T710insD in exon 18 who had a good response to afatinib [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Better Progression-Free Survival in Elderly Patients with Stage IV Lung Adenocarcinoma Harboring Uncommon Epidermal Growth Factor Receptor Mutations Treated with the First-line Tyrosine Kinase Inhibitors

Tsai

Hung

Lee

et al. 2018

Cancers

View full text Add to dashboard Cite

Patients with lung adenocarcinoma harboring common epidermal growth factor receptor (EGFR) mutations usually have a good response rate (RR) and longer progression-free survival (PFS) to EGFR tyrosine kinase inhibitors (TKIs). However, the treatment efficacy to uncommon EGFR mutations remains controversial. We, therefore, performed a retrospective study, screening 2958 patients. A total of 67 patients with lung adenocarcinoma harboring uncommon EGFR mutations were enrolled and 57 patients with stage IV diseases receiving a first-line EGFR TKI were included for further analyses. The patients were classified into 27 (47%) “a single sensitizing uncommon mutation”, 7 (12%) “multiple sensitizing mutations”, 5 (9%) “a sensitizing mutation and a resistant uncommon mutation”, and 18 (32%) “other resistant uncommon mutations”. No significant difference was noted in PFS or overall survival (OS) between groups. Patients receiving different first-line EGFR TKIs had similar PFS and OS. The elder patients had a significantly poorer performance status than the younger patients but a significantly longer PFS than the younger patients (median PFS: 10.5 vs. 5.5 months, p = 0.0320). In conclusion, this is the first study to identify that elderly patients with stage IV lung adenocarcinoma harboring uncommon EGFR mutation might have a longer PFS. Large-scale prospective studies are mandatory to prove our findings.

show abstract

Section: Discussionmentioning

confidence: 99%

Better Progression-Free Survival in Elderly Patients with Stage IV Lung Adenocarcinoma Harboring Uncommon Epidermal Growth Factor Receptor Mutations Treated with the First-line Tyrosine Kinase Inhibitors

Tsai

Hung

Lee

et al. 2018

Cancers

View full text Add to dashboard Cite

show abstract

“…And the PFS of them was only about 4 months, as reported 11. A few cases reported that the treatment of afatinib to patients with adenocarcinoma harboring delE709_T710insD successfully shrank the tumor, but the data on prognosis are incomplete 6,12,13. It has also been reported that, compared to first generation or third generation-TKIs, afatinib appeared to have high sensitivity to del 18 in the in vitro study 6.…”

Section: Discussionmentioning

confidence: 87%

“…According to the COSMIC database, delE709_T710insD mutation accounts for 0.11% among all EGFR mutations 12. It is the most common deletion, with E709K and G719A being the most common point mutations in exon 18 mutations 13. Wu et al14 reported that, in 3,146 patients with NSCLC, there were 25 cases with exon 18 deletion mutations, accounting for 0.79% of all patients, and 1.48% carrying EGFR mutations.…”

Section: Discussionmentioning

confidence: 99%

<p>Great efficacy of afatinib on a patient with lung adenocarcinoma harboring uncommon EGFR delE709_T710insD mutations: a case report</p>

An¹,

Wang²,

Zhu³

et al. 2019

OTT

View full text Add to dashboard Cite

EGFR)-targeted drugs have been the first-line treatment for patients with EGFR-mutant non-small cell lung cancer (NSCLC), especially exon 19 deletions and L858R mutation in exon 21. However, there is insufficient evidence for other less common types of EGFR mutations, such as delE709_T710insD (del 18). Recent studies have revealed that these rare genotypes could be targetable if appropriate mutations, such as delE709_T710insD (del 18). Recent studies have revealed that these rare genotypes could be targetable if appropriate EGFR tyrosine kinase inhibitors are selected. Here we reported a stage Ⅳ NSCLC patient with delE709_T710insD mutation who responded well to afatinib, a second-generation TKI. Afatinib had taken good control of the patient’s brain metastasis with a progression-free survival of 11 months and an overall survival exceeded 21 months, although he had received multi-line therapy. This case demonstrates EGFR delE709_T710insD is a rare but potentially afatinib responsive mutation in NSCLC, which may contribute to changes in clinical practice and further research into the precise detection and treatment of rare mutations in EGFR.

show abstract

“…Among all the exon 18 deletion mutations, the delE790_T710insD mutation is another common mutation type, accounting for approximately 0.30% of the total EGFR mutations [28]. A case report showed that after two months of treatment with afatinib in a patient with a mutation, imaging showed that the lesion was signi cantly reduced [32]. An et al [33] reported that after 3 months of treatment with afatinib, brain metastasis was signi cantly reduced, reached PR, and was maintained for 11 months in a Chinese patient with the delE790_T710insD mutation.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Afatinib in Non-small Cell Lung Cancer Patients Harboring Uncommon Epidermal Growth Factor Receptor Mutations

Zhao¹,

Hu²,

Dong³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Uncommon epidermal growth factor receptor (EGFR) mutations are a heterogeneous population of molecular alterations, and clinical data on the outcomes of afatinib in patients with non-small cell lung cancer (NSCLC) harboring uncommon EGFR mutations are limited. The purpose of this pooled analysis was to investigate the clinicopathological features of uncommon EGFR mutations in patients and the treatment response and survival associated with afatinib treatment.Methods: We performed a literature search in the NCBI PubMed database to identify relevant articles and completed a pooled analysis based on 37 related published studies.The relationship between clinical characteristics, EGFR mutation type and treatment response were analyzed using univariate chi-square analysis, and survival analysis was performed using the Kaplan–Meier method.Results: A total of 57 patients were included in this pooled analysis. The objective response rate to treatment with afatinib was 46.4%, with a median PFS of 7.0 months.Patients with a single uncommon EGFR mutation are more likely than patients with multiple mutations to show a good tumor response after receiving afatinib (ORR: 57.9% vs 26.3%, HR: 0.260, 95% CI: 0.078-0.869, p=0.029). Similarly, patients with a single uncommon EGFR mutation had a longer PFS than patients with multiple mutations (mPFS: 10.0 months vs 3.6 months, HR: 2.906, 95% CI: 1.496-5.646, p=0.002). In addition, for patients with a good treatment response, the PFS was also longer (HR: 2.902, 95% CI: 1.522-5.533, p=0.001).Conclusions: For patients with uncommon mutations, the outcomes of afatinib is worse than that of patients with classic sensitive mutations but higher than that of EGFR wild-type patients. Uncommon EGFR mutations contain various subtypes, and different subtypes have different sensitivities to afatinib. Patients with a single rare mutation show better treatment responses to afatinib and better prognoses than patients with multiple mutations.

show abstract

EGFR exon 18 delE709_T710insD mutated stage IV lung adenocarcinoma with response to afatinib

Cited by 21 publications

References 9 publications

Better Progression-Free Survival in Elderly Patients with Stage IV Lung Adenocarcinoma Harboring Uncommon Epidermal Growth Factor Receptor Mutations Treated with the First-line Tyrosine Kinase Inhibitors

Better Progression-Free Survival in Elderly Patients with Stage IV Lung Adenocarcinoma Harboring Uncommon Epidermal Growth Factor Receptor Mutations Treated with the First-line Tyrosine Kinase Inhibitors

<p>Great efficacy of afatinib on a patient with lung adenocarcinoma harboring uncommon EGFR delE709_T710insD mutations: a case report</p>

Outcomes of Afatinib in Non-small Cell Lung Cancer Patients Harboring Uncommon Epidermal Growth Factor Receptor Mutations

Contact Info

Product

Resources

About