2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.93 (Poster) RET Fusion as a Treatable Resistance Mechanism in EGFR Mutation Lung Cancer

PP01.93 (Poster) RET Fusion as a Treatable Resistance Mechanism in EGFR Mutation Lung Cancer - A Case Report

Pdf Summary

A case report published in the journal Cancer Science describes the successful treatment of a patient with non-small cell lung cancer (NSCLC) who had acquired resistance to the drug osimertinib due to the development of a RET fusion gene. The RET gene fusion is one of the molecular abnormalities that can cause resistance to osimertinib in NSCLC patients with epidermal growth factor receptor (EGFR) mutations. The patient in this case had an EGFR mutation and initially responded to osimertinib but eventually developed resistance. Molecular testing revealed the presence of a RET fusion, and the patient was subsequently treated with a combination of EGFR and RET inhibitors. This combination therapy resulted in a complete response, with no radiographic evidence of cancer and a reasonable quality of life. Brain metastases, which are common in EGFR mutated and RET fusion positive lung cancer patients, were effectively treated with targeted therapy in conjunction with radiotherapy. The case report emphasizes the importance of molecular testing at the time of diagnosis and at the time of progression to identify resistance mutations. It also suggests that oncologists may have to rely on case reports and case series to make treatment decisions in the absence of clinical trials. However, it is noted that insurance coverage for these targeted therapies may be a challenge due to the need for multiple medications. The authors plan to publish this case report in a peer-reviewed journal to benefit other patients.

Asset Subtitle

Vivek Athipatla

Keywords

case report

Cancer Science

non-small cell lung cancer

NSCLC

osimertinib

acquired resistance

RET fusion gene

EGFR mutations

molecular testing

combination therapy