scholarly journals Case Report: Dacomitinib Overcomes Osimertinib Resistance in NSCLC Patient Harboring L718Q Mutation: A Case Report

2021 ◽  
Vol 11 ◽  
Author(s):  
Qian Shen ◽  
Jingjing Qu ◽  
Zhen Chen ◽  
Jianying Zhou
Keyword(s):  
Case Report ◽  
Disease Progression ◽  
Gamma Knife ◽  
Parietal Lobe ◽  
Brain Mri ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Subset ◽  
Small Cell Lung

BackgroundAdvanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations has been successfully treated with tyrosine kinase inhibitors (TKIs). However, resistance to osimertinib, a third-generation TKI, can be difficult to overcome in this small subset of patients and is attributed to secondary resistant mutations. Here, we report a case of acquired EGFR L858R/L718Q mutation with advanced NSCLC that resistant to osimertinib, which was successfully overcome using dacomitinib.Case PresentationA 64-year-old non-smoker woman was diagnosed with stage IV non-small cell lung adenocarcinoma with EGFR L858R mutation and brain metastasis in November 2018. Treatment with gefitinib and gamma knife radiosurgery was started as the first-line treatment. After 7 months, she experienced disease progression with increased primary lung lesions and switched to osimertinib based on an acquired EGFR T790M mutation. After another 4 months, the disease progressed, and she was switched to chemotherapy. During chemotherapy, brain MRI showed an increasing number of parietal lobe metastases. Hence, gamma knife radiosurgery was performed again. After 12 months, the disease progression resumed, and an EGFR L718Q mutation was found on biopsy. The patient was then challenged with dacomitinib, and the disease was partially responsive and under control for 6 months.ConclusionCurrently, there are no established guidelines for overcoming osimertinib resistance caused by the L718Q mutation. The acquired EGFR L718Q mutation in subsequent resistance to osimertinib could be overcome using dacomitinib, indicating a promising treatment option in the clinic.

Gamma Knife Radiosurgery for Treatment of Cerebral Metastases From Non–Small-Cell Lung Cancer

2011 ◽  
Vol 81 (4) ◽  
pp. e463-e468 ◽  
Author(s):  
Micaela Motta ◽  
Antonella del Vecchio ◽  
Luca Attuati ◽  
Piero Picozzi ◽  
Lucia. Perna ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Cerebral Metastases ◽  
Small Cell Lung

scholarly journals Prognosis of Non-Small Cell Lung Cancer with Synchronous Brain Metastases Treated with Gamma Knife Radiosurgery

2006 ◽  
Vol 21 (3) ◽  
pp. 527 ◽  
Author(s):  
Doo-Sik Kong ◽  
Jung-Il Lee ◽  
Do Hyun Nam ◽  
Kwan Park ◽  
Jong Hyun Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung

scholarly journals Gamma Knife Radiosurgery for Brain Metastases in Non-Small Cell Lung Cancer Patients Treated with Immunotherapy or Targeted Therapy

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3668
Author(s):  
Anna Cho ◽  
Helena Untersteiner ◽  
Dorian Hirschmann ◽  
Abdallah Shaltout ◽  
Philipp Göbl ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Combined Treatment ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung

The combination of Gamma Knife radiosurgery (GKRS) and systemic immunotherapy (IT) or targeted therapy (TT) is a novel treatment method for brain metastases (BMs) in non-small cell lung cancer (NSCLC). To elucidate the safety and efficacy of concomitant IT or TT on the outcome after GKRS, 496 NSCLC patients with BMs, who were treated with GKRS were retrospectively reviewed. The median time between the initial lung cancer diagnosis and the diagnosis of brain metastases was one month. The survival after the initial BM diagnosis was significantly longer than the survival predicted by prognostic BM scores. After the first Gamma Knife radiosurgery treatment (GKRS1), the estimated median survival was 9.9 months (95% CI = 8.3–11.4). Patients with concurrent IT or TT presented with a significantly longer survival after GKRS1 than patients without IT or TT (p < 0.001). These significant differences in the survival were also apparent among the four treatment groups and remained significant after adjustment for Karnofsky performance status scale (KPS), recursive partitioning analysis (RPA) class, sex, and multiple BMs. About half of all our patients (46%) developed new distant BMs after GKRS1. Of note, no statistically significant differences in the occurrence of radiation reaction, radiation necrosis, or intralesional hemorrhage in association with IT or TT at or after GKRS1 were observed. In NSCLC-BM patients, the concomitant use of GKRS and IT or TT showed an increase in overall survival without increased complications related to GKRS. Therefore, the combined treatment with GKRS and IT or TT seems to be a safe and powerful treatment option and emphasizes the role of radiosurgery in modern BM treatment.

scholarly journals Continued gefitinib retreatment beyond progression in patients with advanced non-small cell lung cancer harboring sensitive EGFR mutations

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052095503
Author(s):  
Xuhong Jiang ◽  
Xiaoqing Li ◽  
Lingli Tu ◽  
Jin Cai ◽  
Man Wei ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Disease Progression ◽  
Cell Lung Cancer ◽  
Evaluation Criteria ◽  
Growth Factor Receptor ◽  
Progression Free Survival ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Cell Lung

Purpose To evaluate the effectiveness and safety of gefitinib retreatment beyond disease progression in patients with advanced non-small cell lung cancer (NSCLC) with sensitive epidermal growth factor receptor ( EGFR) mutations. Methods Data from patients with stage III/IV NSCLC were analyzed retrospectively. Patients with sensitive EGFR mutations received first-line treatment with gefitinib followed by retreatment with gefitinib after disease progression. Progression-free survival (PFS) after the first treatment (PFS-1) was defined as the time to progression or death using the Response Evaluation Criteria in Solid Tumors criteria (RECIST) v1.1 criteria. The second PFS (PFS-2) was defined as the interval between the first and second progressions, at the investigator’s discretion. Toxicities were recorded in accordance with the National Cancer Institute (NCI)-Common Terminology Criteria (CTC) version 4.0. Results Sixteen patients aged 53 to 80 years (median 66 years) were included in the analysis. The median PFS-1 and PFS-2 were 10.0 months and 14.0 months, respectively. The median overall survival (OS) was 36.0 months. No toxicity of grade 3 or worse was observed. Conclusions Our findings suggest that gefitinib retreatment beyond disease progression may be an effective and tolerable approach for NSCLC patients with sensitive EGFR mutations.

EGFR mutations in malignant pleural effusion of non-small cell lung cancer: A case report

Lung Cancer ◽  
2005 ◽  
Vol 49 (3) ◽  
pp. 413-415 ◽  
Author(s):  
Ming-Jer Huang ◽  
Ken-Hong Lim ◽  
Chin-Yuan Tzen ◽  
Han-Shui Hsu ◽  
Yun Yen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Pleural Effusion ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Malignant Pleural Effusion ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Cell Lung

scholarly journals Role of Gamma Knife Radiosurgery in Small Cell Lung Cancer: A Multi-Institutional Retrospective Study of the International Radiosurgery Research Foundation (IRRF)

Neurosurgery ◽  
2021 ◽  
Vol 89 (Supplement_2) ◽  
pp. S20-S20
Author(s):  
Christopher P Cifarelli ◽  
John A Vargo ◽  
Wei Fang ◽  
Roman Liscak ◽  
Khumar Guseynova ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Retrospective Study ◽  
Small Cell Lung Cancer ◽  
Gamma Knife ◽  
Cell Lung Cancer ◽  
Gamma Knife Radiosurgery ◽  
Small Cell ◽  
Small Cell Lung
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