Objective To investigate the mechanism of acquired resistance to afatinib and related therapeutic strategy.Methods This article reported the clinical data of a patient with advanced lung adenocarcinoma who had epidermal growth factor receptor(EGFR)T790M and C797S trans-mutations after treatment with afatinib,and a literature review was performed to sum-marize the clinical features and diagnosis and treatment experience of the disease.Results In this case,the patient with advanced lung adenocarcinoma was found to have an EGFR 19Del mutation at initial diagnosis,and after the first-line targeted therapy with afatinib,the patient was found to have rare EGFR T790M and C797S trans-mutations in the genetic testing of pleural effusion.The treatment regimen was adjusted to the first-generation tyrosine kinase inhibitor(TKI)gefitinib combined with the third-generation TKI osimertinib,and the patient achieved 9 months of event-free survival and 51 months of overall survival.Conclusion EGFR T790M/C797S trans-mutations caused by afatinib are rare in the treatment of lung adenocarcinoma,and C797S mutation may be a potential resistance mechanism of afatinib.First-generation TKIs combined with third-generation TKIs are effective in the treat-ment of lung adenocarcinoma patients with EGFR T790M/C797S trans-mutations.
关键词
阿法替尼/肺腺癌/ErbB受体/突变/病例报告
Key words
afatinib/adenocarcinoma of lung/ErbB eceptors/mutation/case reports
维普
万方数据