2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.093 Vivek Athipatla NACLC23 Abstract

PP01.093 Vivek Athipatla NACLC23 Abstract

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The 2023 North America Conference on Lung Cancer featured a case report on the treatment of a patient with EGFR mutation lung cancer who developed acquired resistance to osimertinib due to a RET fusion. The report emphasizes the importance of testing for molecular alterations in lung cancer at diagnosis and at the time of progression to identify resistance mutations. <br /><br />The patient, a 60-year-old Asian male, was diagnosed with stage IV non-small cell lung cancer (NSCLC) in mid-2019. He had an EGFR mutation and started treatment with osimertinib. However, after about 24 months, the patient showed progression on scans. Liver biopsy in August 2021 revealed a RET fusion, and the patient received chemo-immunotherapy with minimal response until March 2022 when it was stopped due to progression. <br /><br />In the absence of standard guidelines, the patient was given pralsetinib (a RET inhibitor) in combination with restarting osimertinib in April 2022. The patient experienced immediate symptomatic improvement, and a positron emission tomography (PET) scan showed a complete response. As of August 2023, the patient continues to be on this treatment regimen with no evidence of disease. <br /><br />The case highlights the efficacy of combined EGFR and RET inhibition in treating patients with EGFR mutation lung cancer who develop acquired resistance to osimertinib due to a RET fusion. It also emphasizes the importance of targeted therapy in conjunction with radiotherapy for patients with brain metastases, which are common in patients with EGFR mutated and RET fusion positive lung cancer. <br /><br />The report suggests that oncologists may need to rely on case reports and case series to make the best treatment decisions for their patients. Overall, this case contributes to the growing understanding of resistance mechanisms and targeted therapies in lung cancer, specifically regarding EGFR mutations and RET fusions.

Keywords

2023 North America Conference on Lung Cancer

case report

EGFR mutation lung cancer

acquired resistance

osimertinib

RET fusion

molecular alterations

chemo-immunotherapy

pralsetinib

targeted therapies