Bevacizumab Combined with Icotinib Overcomes Osimertinib Resistance in a Patient of Non-Small Cell Lung Cancer

Publication date: December 2019Source: Chinese Medical Sciences Journal, Volume 34, Issue 4Author(s): Ling Zhang, Lei Sun, Xiaoyan Mu, Youxin JiAbstractA 61-year-old Chinese woman was diagnosed as primary pulmonary adenocarcinoma of left superior lobe with epidermal growth factor receptor (EGFR) 19 del mutation positive. Treatment with icotinib was given, but her disease progressed after 6 months remission. CT-guide needle biopsy for the new lesion in inferior lobe of left lung demonstrated intrapulmonary metastasis, and EGFR gene panel by Amplification Refractory Mutation System Polymerase Chain Reaction (ARMS-PCR) confirmed EGFR T790M mutation. Treatment with osimertinib was initiated. After 2 months remission, the disease progressed. Re-biopsy was performed for the tumor in the inferior lobe of left lung, and ARMS-PCR demonstrated no other gene mutation except EGFR 19 del. Icotinib was re-challenged, but disease progressed continuously. Bevacizumab was added, and partial response was achieved after 2-cycle of combination therapy. The non-small cell lung cancer (NSCLC) in this case maintained EGFR activating mutation and lost EGFR T790M mutation was a genetic change after osimertinib treatment. This case suggests the re-challenge of the first-generation EGFR-TKIs combined with bevacizumab may overcome the tumor resistance and prolong survival of NSCLC patient.
Source: Chinese Medical Sciences Journal - Category: General Medicine Source Type: research

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Conditions:   Pancreatic Ductal Adenocarcinoma;   Non-small Cell Lung Cancer;   Squamous Cell Carcinoma of Head and Neck Interventions:   Biological: Durvalumab;   Biological: Oleclumab Sponsors:   University Health Network, Toronto;   AstraZeneca Not yet recruiting
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