文章摘要

奥希替尼治疗经埃克替尼一线治疗后进展并继发T790M突变的肺腺癌1例

作者: 1黄 锦宏, 1张 晓东, 1由 振华, 1程 易, 1赵 云根
1 徐州医科大学附属常熟医院呼吸内科,江苏 常熟 215500
通讯: 黄 锦宏 Email: john126272@sohu.com
DOI: 10.3978/j.issn.2095-6959.2020.01.043

摘要

徐州医科大学附属常熟医院收治1例埃克替尼治疗进展后继发T790M突变的肺腺癌接受二线奥希替尼治疗的女性患者。该患者70岁,反复咳嗽咳痰15年,加重半月;CT提示右肺中叶实变影,大量胸腔积液;病理报告:(胸水细胞块)转移性腺癌,倾向肺来源;血液基因检测示EGFR 19Del合并TP53突变;口服埃克替尼125 mg,每天3次,10个月后疾病进展,再次血液基因检测T790M突变,口服奥希替尼80 mg,每天1次,随访至今(9个月),疾病达到部分缓解(partial response,PR)。因此,晚期非小细胞肺癌患者治疗前应明确基因状态,对于阳性患者给与表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKIs)治疗,可以使患者获得更长的总生存期和更好的生活质量。
关键词: 非小细胞肺癌;T790M;奥希替尼

A case of osimertinib for lung adenocarcinoma patient with secondary T790M mutation after icotinib

Authors: 1HUANG Jinhong, 1ZHANG Xiaodong, 1YOU Zhenhua, 1CHEN Yi, 1ZHAO Yungen
1 Department of Respiratory Medicine, Affiliated Changshu Hospital of Xuzhou Medicinal University, Changshu Jiangsu 215500, China

CorrespondingAuthor:HUANG Jinhong Email: john126272@sohu.com

Abstract

A lung adenocarcinoma patient who had secondary T790M mutation after icotinib was admitted to the Affiliated Changshu Hospital of Xuzhou Medicinal University with second-line osimertinib. The patient is a 70-year-old woman having recurrent cough and phlegm for 15 years and had been aggravated in the past half a month. CT showed consolidation of right middle lob and pleural effusion; pathology report expressed the metastatic adenocarcinoma of pleural fluid cell mass from lung; blood gene detection said EGFR 19Del combined with TP53 mutation said TP53 mutation again after 10-month oral icotinib 125 mg, 3 times a day. The 9-month follow-up visit after oral osimertinib 80 mg once a day reported partial response (PR). Therefore, patients with advanced non-small cell lung cancer should have a clear genetic status before the treatment. The positive patients with TKI treatment can get longer overall survival and have a better life.
Keywords: non-small cell lung cancer; T790M; osimertinib