2023 World Conference on Lung Cancer (Posters)-EP12.01. Good Results of Osimertinib in a Patient with EGFR (L861Q) and MET Amplification NSCLC: A Case Report

EP12.01. Good Results of Osimertinib in a Patient with EGFR (L861Q) and MET Amplification NSCLC: A Case Report - PDF(Abstract)

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In this case report, the authors discuss the treatment and clinical course of a 62-year-old man with metastatic non-small cell lung cancer (NSCLC) harboring an uncommon EGFR mutation (L861Q) and MET amplification. The patient initially presented with neck and lumbar pain, and a CT scan revealed a mass in the upper lobe of the right lung, which was diagnosed as a pleomorphic poorly differentiated infiltrating adenocarcinoma with metastases to the esophagus and bone.<br /><br />The patient was treated with Osimertinib 80 mg daily, along with denosumab and radiotherapy to the cervical spine. He showed good tolerance to the drug and achieved partial response on two occasions. However, he developed severe cognitive impairment and was hospitalized in the intensive care unit. An MRI revealed metastatic subcortical lesions in the brain and narrowing of the cervical canal.<br /><br />Further analysis of cerebrospinal fluid showed the development of a resistance mutation (MET amplification), for which Amivantamab was requested but not available for administration. Palliative measures were continued until the patient's unfortunate death.<br /><br />The authors highlight the rarity of the EGFR mutation (L861Q) and its known resistance to EGFR-targeted therapies, as well as the development of MET amplification as a mechanism of resistance. Despite achieving a partial response and a progression-free survival rate of 8.13 months, the patient could not receive appropriate treatment for the acquired resistance due to the unavailability of a specific drug.<br /><br />This case report emphasizes the challenges in managing metastatic NSCLC with uncommon EGFR mutations and secondary resistance mechanisms like MET amplification. It underscores the need for access to effective targeted therapies and highlights the importance of ongoing research to develop novel treatment strategies for patients with rare mutations and acquired resistance.

Asset Subtitle

Iván Romarico González-Espinoza

Meta Tag

Speaker Iván Romarico González-Espinoza

Topic Metastatic NSCLC: Targeted Therapy - EGFR/HER2

Keywords

case report

metastatic non-small cell lung cancer

EGFR mutation

L861Q

MET amplification

treatment

clinical course

resistance mechanisms

targeted therapies

rare mutations