Efficacy of afatinib in a patient with rare EGFR(G724S/R776H)mutations and amplification in lung adenocarcinoma:A case report

摘要

BACKGROUND The most common EGFR mutations are in-frame deletions in exon 19 and point mutations in exon 21.Cases with classical EGFR mutations show a good response to EGFR tyrosine kinase inhibitors(TKIs),the standard first-line treatment.With the development of next generation sequencing,some uncommon genomic mutations have been detected.However,the effect of TKIs on such uncommon EGFR mutations remains unclear.CASE SUMMARY Here,we report a case of rare EGFR co-mutation in non-small cell lung cancer and the efficacy of afatinib on this EGFR co-mutation.A 64-year-old woman was diagnosed with thoracolumbar and bilateral local rib bone metastases,bilateral pulmonary nodules,and pericardial and left pleural effusion.The pathological diagnosis was lung adenocarcinoma.To seek potential therapeutic regimens,rare co-mutation comprising rare EGFR G724S/R776H mutations and amplification were identified.The patient experienced a significant clinical response with a progression-free survival of 17 mo.CONCLUSION A case of non-small cell lung cancer with rare EGFR G724S/R776H mutations and EGFR amplification responds well to TKI treatment.