A rare epidermal growth factor receptor H773L/V774M compound mutation in advanced non ‐small‐cell lung cancer with poor response to epidermal growth factor receptor tyrosine kinase inhibitor

Here, we report a case of advanced non ‐small‐cell lung cancer with a rare epidermal growth factor receptor (EGFR) exon 20 H773L/V774M compound mutation, which demonstrated poor clinical response to afatinib, a second‐generation EGFR‐TKI with pan‐human EGFR blocking activity. The anti‐cancer treatment was shifted to platinum‐ based chemotherapy, which resulted in a partial response. Uncommon mutations account for 10 –15% of epidermal growth factor receptor (EGFR) mutations in patients with non‐small‐cell lung cancer. Afatinib is currently the most efficient EGFR‐tyrosine kinase inhibitor (TKI) against uncommon EGFR mutations. Here we report a 56‐year‐old woman presenting with persistent cough for on e month. She was diagnosed with stage IV lung adenocarcinoma by bronchoscopic biopsy to the left lower lung tumour and serial image modalities. A rare H773L/V774M compound mutation in exon 20 was detected by gene sequencing. The patient received first‐line afatinib but primary resistance was noted with rapid left lower lung tumour progression. Second‐line chemotherapy combined with bevacizumab, pemetrexed, and cisplatin demonstrated more durable response. Our case suggests that H773L/V774M may be one of the EGFR‐TKI‐resistant uncommon EGFR mutations.
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research

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Conclusions: Hypofractionated carbon-ion RT showed excellent local control and overall survival without severe toxicities in lung cancer patients with isolated lymph node metastasis after surgery or carbon-ion RT for primary lung tumors. A multi-institutional prospective study is required to establish the efficacy and safety of carbon-ion RT.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusion Diagnosis of pneumonic-type carcinoma is usually delayed due to clinical and radiological features mimicking pulmonary infection. TBLB combined with BAL has a quite high diagnostic yield. The most frequent histological type is invasive mucinous adenocarcinoma. The incidence of EGFR mutation or ALK rearrangement is low in pneumonic-type carcinoma. For patients without cancer driver genes, chemotherapy is recommended to improve overall survival. 
 DOI: 10.3779/j.issn.1009-3419.2019.06.01
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
This is a nation ‐wide multicenter 10‐year cross‐sectional study in China. This paper tried to objectively examine the symptoms and physical signs in lung cancer patients, and determine whether lung cancer symptoms were independently associated with diagnosis. We found that the symptoms and physical signs were  associated with stage and pathologic diagnosis of NSCLC. AbstractBackgroundMost lung cancer patients are diagnosed after the onset of symptoms. However, whether the symptoms of lung cancer were independently associated with the diagnosis of lung cancer is unknown, especially in the Chinese population...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Publication date: Available online 27 May 2019Source: Respiratory Medicine Case ReportsAuthor(s): Takafumi Yamaya, Hwang Moon Hee, Takayuki Aoyagi, Tatsuya Ogimoto, Naoki Yamada, Ryoichi Ishikawa, Erika Nakai, Kenta Nishi, Chie Yoshimura, Yasuo NishizakaAbstractImmune checkpoint inhibitors (ICIs) have been used to treat lung cancer. Several types of ICI-related interstitial lung diseases have been reported, including organizing pneumonia, non-specific interstitial pneumonia, and diffuse alveolar damage. However, pembrolizumab-associated bronchiolitis requiring treatment for persistent cough has not yet been reported. Here,...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Publication date: June 2019Source: Cancer Epidemiology, Volume 60Author(s): G. Kourlaba, I. Gkiozos, E. Kokkotou, G. Stefanou, A. Papaspiliou, K. SyrigosAbstractBackgroundTo map the patients’ journey from symptoms onset to treatment initiation for the most frequent histological types of lung cancer in Greece and describe the initial treatment that patients receive.MethodsThe primary data source was a Greek hospital-based registry. Demographic, anthropometric, lifestyle, and diagnostic-related characteristics as well as treatment-related data were extracted from the registry for patients diagnosed with Adenocarcinoma,...
Source: Cancer Epidemiology - Category: Cancer & Oncology Source Type: research
Mark E. Gray1,2*, James Meehan2,3, Paul Sullivan4, Jamie R. K. Marland4, Stephen N. Greenhalgh1, Rachael Gregson1, Richard Eddie Clutton1, Carol Ward2, Chris Cousens5, David J. Griffiths5, Alan Murray4 and David Argyle1 1The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Edinburgh, United Kingdom 2Cancer Research UK Edinburgh Centre and Division of Pathology Laboratories, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom 3School of Engineering and Physical Sciences, Institute of Sensors, Signals and Systems, Heriot-Watt Univer...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Rationale: The anaplastic lymphoma kinase (ALK) rearrangements represent a subtype of nonsmall-cell lung cancer (NSCLC), and targeting ALK has radically changed the treatment of NSCLC. Crizotinib, as an ALK inhibitor, has been used in the treatment of ALK-rearranged NSCLC for several years and some adverse effects should be given attention. Patient concerns: A 64-year-old woman with a no-smoking history visited hospital in November 2016 because of a persistent cough, expectoration, and progressive dysphagia for 2 months. Diagnoses and interventions: She was diagnosed with primary lung adenocarcinoma, accompanied by...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Publication date: Available online 19 February 2019Source: Respiratory Medicine Case ReportsAuthor(s): Takehiro Izumo, Yuriko Terada, Mari Tone, Minoru Inomata, Naoyuki Kuse, Nobuyasu Awano, Atsuko Moriya, Tatsunori Jo, Hanako Yoshimura, Yoshiaki FuruhataAbstractSevere bronchial asthma is a chronic disorder of the airways that may be accompanied by comorbid diseases. Invasive treatment, including surgery, in patients with severe asthma has limitations depending on the degree of control of the asthma. A 71-year-old woman was diagnosed with adenocarcinoma with high programmed death-ligand 1 (PD-L1) expression and cT3N0M1a. A...
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
A 58 ‐year‐old man presented with a two‐month history of facial erythema and dry cough. After testing he was diagnosed with co‐occurring transcriptional intermediary factor 1‐gamma (TIF1‐γ) positive dermatomyositis (DM) and lung adenocarcinoma. He subsequently developed muscle weakness and w as administered oral prednisolone but developed TIF1‐γ positive DM‐associated oropharyngeal dysphagia complicated by spontaneous oesophageal rupture. Despite treatment, he gradually deteriorated and died from progression of chemoresistant lung cancer six months later. A 58 ‐year‐old man presented with a ...
Source: Respirology Case Reports - Category: Respiratory Medicine Authors: Tags: Case Report Source Type: research
Rationale: Comprehensive genomic profiling for non-small cell lung cancer (NSCLC) is likely to identify more patients with rare genetic alterations, including uncommon epidermal growth factor receptor (EGFR) gene mutation. Patient concerns: A 63-year-old Chinese woman who had never smoked visited our lung cancer clinic due to a chronic cough. Diagnosis: The patient was diagnosed with lung adenocarcinoma by transbronchial lung biopsy. An EGFR mutation (exon 20 insertion H773_V774insH, D770_N771insG, V769_D770insASV, D770_N771insSVD) was detected in the biopsy specimen by quantitative real-time PCR. Interventions: ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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