Icotinib/nedaplatin/pemetrexed

Abstract

Icotinib/nedaplatin/pemetrexedAcquired drug resistance, nausea and vomiting: case report An approximately 75-year-old man developed nausea and vomiting during chemotherapy with nedaplatin and pemetrexed, and acquired drug resistance during treatment with icotinib for stage IV left lung adenocarcinoma [durations of treatments to reactions onsets and outcomes stated].The man was diagnosed with stage IV left lung adenocarcinoma on 12 September 2015 at the age of 74 years. His mutation analysis showed exon 19 deletion in epidermal growth factor receptor (EGFR). From 22 September 2015, he started receiving oral icotinib 125 mg/day. Thereafter, a significant improvement in the lesions was noted. On 5 September 2016, reexamination (chest CT scan) showed an enlargement in the lesion. Hence, he additionally received three cycles of chemotherapy with nedaplatin and pemetrexed [dosages and routes not stated], and chest CT scan demonstrated stable lesion. However, he developed nausea and vomiting secondary to the chemotherapy.The man's chemotherapy with nedaplatin and pemetrexed was discontinued. On 16 August 2017, a CT scan showed progression of lung adenocarcinoma. He underwent liquid biopsy with next-generation sequencing (NGS) and the results showed EGFR exon 19 deletion, T790M point mutation and EGFR amplification. The presence of EGFR T790M point mutation and EGFR amplification confirmed the acquired drug resistance to icotinib. The treatment with icotinib was continued at same dose, and he was stated on osimertinib additionally. On 12 October 2017, a chest CT scan showed significant reduction in the lesion. From February 2018-September 2019 (i.e. at his last follow-up), his lung lesions remained stable with the combination therapy of icotinib and osimertinib.