Bevacizumab Combined with Icotinib Overcomes Osimertinib Resistance in a Patient of Non-Small Cell Lung Cancer.
- Author:
Ling ZHANG
1
;
Lei SUN
1
;
Xiao-Yan MU
2
;
You-Xin JI
2
Author Information
- Publication Type:Journal Article
- Keywords: Epidermal growth factor receptor-tyrosine kinase inhibitor; bevacizumab; non-small cell lung cancer; resistant mutation
- MeSH: Acrylamides/therapeutic use*; Adenocarcinoma of Lung/pathology*; Aniline Compounds/therapeutic use*; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*; Bevacizumab/therapeutic use*; Carcinoma, Non-Small-Cell Lung/pathology*; Cell Line, Tumor; Crown Ethers/therapeutic use*; Drug Resistance, Neoplasm/drug effects*; Female; Humans; Lung Neoplasms/pathology*; Middle Aged; Quinazolines/therapeutic use*; Tomography, X-Ray Computed; Treatment Outcome
- From: Chinese Medical Sciences Journal 2019;34(4):292-296
- CountryChina
- Language:English
- Abstract: A 61-year-old Chinese woman was diagnosed as primary pulmonary adenocarcinoma of left superior lobe with epidermal growth factor receptor (EGFR) 19 del mutation positive. Treatment with icotinib was given, but her disease progressed after 6 months remission. CT-guide needle biopsy for the new lesion in inferior lobe of left lung demonstrated intrapulmonary metastasis, and EGFR gene panel by Amplification Refractory Mutation System Polymerase Chain Reaction (ARMS-PCR) confirmed EGFR T790M mutation. Treatment with osimertinib was initiated. After 2 months remission, the disease progressed. Re-biopsy was performed for the tumor in the inferior lobe of left lung, and ARMS-PCR demonstrated no other gene mutation except EGFR 19 del. Icotinib was re-challenged, but disease progressed continuously. Bevacizumab was added, and partial response was achieved after 2-cycle of combination therapy. The non-small cell lung cancer (NSCLC) in this case maintained EGFR activating mutation and lost EGFR T790M mutation was a genetic change after osimertinib treatment. This case suggests the re-challenge of the first-generation EGFR-TKIs combined with bevacizumab may overcome the tumor resistance and prolong survival of NSCLC patient.
