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2023 World Conference on Lung Cancer (Posters)
EP12.01. Brigatinib Restores Disease Control at Se ...
EP12.01. Brigatinib Restores Disease Control at Second Progression on Osimertinib in Metastatic EGFR ex19del Mutated NSCLC with Acquired EML4-ALK Fusion - PDF(Abstract)
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Researchers at Copenhagen University Hospital presented a case report at the WCLC 2023 conference, highlighting the efficacy of targeted therapy in a patient with metastatic non-small cell lung cancer (NSCLC) who had acquired an EML4-ALK fusion. The patient, a 67-year-old woman, was initially diagnosed with EGFR ex19del mutated NSCLC and received first-line treatment with Osimertinib. After 9 months of disease control, she experienced disease progression and underwent a tumor rebiopsy, which did not reveal any new treatment options.<br /><br />Despite this, the patient continued Osimertinib in combination with Carboplatin/Pemetrexed and palliative irradiation. The disease went into remission, but after 3 months, the patient experienced new progression and deteriorated to performance status 2. A rebiopsy was performed, and it revealed acquired amplification of KRAS, EGFR, and CDK6 genes, as well as an EML4-ALK fusion (variant 5a). The patient was then started on ALK-TKI, Brigatinib, while continuing Osimertinib at a reduced dose. After four weeks of combination treatment, the patient's CT scan showed stable disease.<br /><br />The researchers concluded that the acquired EML4-ALK fusion is a rare mechanism of Osimertinib resistance. However, it provides an opportunity for effective and feasible therapy by combining EGFR- and ALK-TKIs. They emphasized the value of rebiopsies, even in heavily pretreated and fragile patients, in identifying new treatment options.
Asset Subtitle
Edyta Urbanska
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Speaker
Edyta Urbanska
Topic
Metastatic NSCLC: Targeted Therapy - EGFR/HER2
Keywords
Copenhagen University Hospital
WCLC 2023 conference
targeted therapy
metastatic non-small cell lung cancer
EML4-ALK fusion
Osimertinib
rebiopsy
KRAS amplification
EGFR amplification
ALK-TKI
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