Case reportDisappearance of an activated EGFR mutation after treatment with EGFR tyrosine kinase inhibitors
Introduction
Lung cancer is the leading cause of cancer deaths worldwide. Although chemotherapy has advanced in the treatment of non-small-cell lung cancer (NSCLC), the prognosis is still poor [1]. Over the last decade, molecular-targeted agents have been introduced in the treatment of NSCLC. Gefitinib and erlotinib are active epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, which have demonstrated significant activity in NSCLC with somatic mutations within the EGFR tyrosine kinase domain [2], [3]. Many new findings have been made using EGFR-mutated lung cancer cell lines [4]. Here, we established a wild-type EGFR lung cancer cell line derived from the patient harboring an activating EGFR mutation and presume that the mutation disappeared after treatment with EGFR tyrosine kinase inhibitors.
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Case presentation
A 34-year-old Japanese woman presented with left supraclavicular lymph node swelling. Her performance status, as defined by Eastern Cooperative Oncology Group criteria, was 1. Computed tomography scans showed a mass on the left lower lobe, pulmonary nodules, and bilateral pleural effusion (Fig. 1). The supraclavicular lymph node biopsy revealed a large-cell carcinoma. Diagnosed with the lung cancer (T4N3M1, stage IV), she received a combination of cisplatin (80 mg/m2, day 1) and docetaxel (60 mg/m
Discussion
The majority of EGFR mutant lung cancers initially sensitive to EGFR tyrosine kinase inhibitors become resistant to these agents within 1 year [2], [3]. Some possible mechanisms for the acquired resistance have been identified, the most common being the development of an EGFR T790 M ‘gatekeeper’ mutation in around 50% of cases [4]. Other mechanisms of acquired resistance include MET amplification, small-cell transition, and epithelial–mesenchymal transition [4], [8]. In approximately 30% of
Conflict of interest of statement
Drs. Takigawa and Kiura have received honoraria for lecturing from AstraZeneca KK and Chugai Pharmaceutical Co. Ltd.
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