2022 World Conference on Lung Cancer (ePosters)-EP08.02-075. Maintained Complete Response for 8+ Years with Erlotinib Alone in Advanced Lung Adenocarcinoma Harboring EGFR Exon 19 Deletion

EP08.02-075. Maintained Complete Response for 8+ Years with Erlotinib Alone in Advanced Lung Adenocarcinoma Harboring EGFR Exon 19 Deletion

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A 59-year-old female diagnosed with advanced lung adenocarcinoma with EGFR exon 19 deletion (ex19del) achieved an exceptional 8-year overall survival (OS) with treatment solely using Erlotinib, an EGFR tyrosine kinase inhibitor (TKI). The patient initially showed a partial response to Erlotinib in June 2014, followed by complete remission in May 2015, which has been maintained continuously until May 2022. The patient's performance status improved from PS1 initially to PS0 since 2015. The only notable toxicity observed was exanthema and paronychia, leading to a reduction in Erlotinib dose to 100 mg daily.<br /><br />The study highlights the rarity of ultra-long survival in patients with EGFR-mutated lung adenocarcinoma, particularly those who have remained on the same treatment regimen since diagnosis. Previous reports have shown a median OS of approximately 31 months for patients with EGFR exon 19 deletions receiving EGFR TKIs. However, factors associated with prolonged survival in these patients are not well-defined.<br /><br />Genomic analysis of the patient's tumor revealed EGFR p.L747_A750delinsP, the known ex19del mutation, along with an ATM loss-of-function mutation, and a rare pathogenic MYC variant. It is speculated that the presence of the MYC variant in combination with the ex19del mutation may have contributed to the exceptional response to Erlotinib observed in this case.<br /><br />The study suggests further investigation to better understand the optimal therapeutic possibilities for different EGFR mutations. Identifying molecular factors associated with prolonged survival may help tailor treatment strategies for patients with EGFR-mutated lung adenocarcinoma.

Asset Subtitle

Jens Benn Sørensen

Meta Tag

Speaker Jens Benn Sørensen

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

lung adenocarcinoma

EGFR exon 19 deletion

Erlotinib

tyrosine kinase inhibitor

overall survival

complete remission

performance status

toxicity

genomic analysis

therapeutic possibilities