title: Repeated favorable responses to epidermal growth factor receptor-tyrosine kinase inhibitors in a case of advanced lung adenocarcinoma.
abstract: The presence of epidermal growth factor receptor (EGFR) mutation is a prognostic and predictive marker for EGFR-tyrosine kinase inhibitor (TKI) therapy. However, inevitably, relapse occurs due to the development of acquired resistance, such as T790M mutation. We report a case of repeated responses to EGFR-TKIs in a never-smoked woman with adenocarcinoma. After six cycles of gemcitabine and cisplatin, the patient was treated by gefitinib for 4 months until progression. Following the six cycles of third-line pemetrexed, gefitinib retreatment was initiated and continued with a partial response for 6 months. After progression, she was recruited for an irreversible EGFR inhibitor trial, and the time to progression was 11 months. Although EGFR direct sequencing on the initial diagnostic specimen revealed a wild-type, we performed a rebiopsy from the progressed subcarinal node at the end of the trial. The result of peptide nucleic acid clamping showed L858R/L861Q.
authors.affiliation: Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Hwasun, Korea. ; Department of Internal Medicine, Chonnam National University Medical School, Hwasun, Korea.
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Kim
authors.forename: Yoon-Hee
authors.initials: YH
authors.lastname: Kim
authors.forename: Hee-Jung
authors.initials: HJ
authors.lastname: Ban
authors.forename: In-Jae
authors.initials: IJ
authors.lastname: Oh
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kwon
authors.forename: Kyu-Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Yu-Il
authors.initials: YI
authors.lastname: Kim
authors.forename: Sung-Chul
authors.initials: SC
authors.lastname: Lim
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Kim
keywords: Adenocarcinoma; Gefitinib; Receptor, Epidermal Growth Factor