title: Reversion of erlotinib-acquired resistance twice by chemotherapy: a case report.
abstract: Epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer (NSCLC) usually develop disease progression after a median of 10 to 14 mo on tyrosine kinase inhibitor (TKI). Several mechanisms of resistance to TKI have been described, threonine-methionine substitution at position 790 (T790M), mesenchymal-epithelial transition factor (MET) amplification, overexpression of hepatocyte growth factor (HGF), upregulation of insulin-like growth factor (IGF) receptor signaling, transformation to small cell lung cancer, and so on. A variety of different therapeutic approaches aimed at overcoming resistance are motivated, irreversible EGFR inhibitors, combination with EGFR targeted antibodies, mesenchymal-epithelial transition factor (MET) inhibitors, HGF inhibitors, and so forth. Nevertheless, the results were not optimistic. Here we report a case of reversion of erlotinib-acquired resistance twice, and had a good improvement of outcomes every time. There are some possible reasons for this phenomenon. Considering this report, the patients who acquired resistance after retreatment of EGFR-TKI, using EGFR-TKI repeatedly may be a choice selectively.
authors: Department of Radiation Oncology; Shandong Tumor Hospital and Institute; Shandong University; Jinan, PR China.
authors: Fei-fei
authors: FF
authors: Teng
authors: Department of Radiation Oncology; Qianfuo Mountain Hospital; Shandong University; Jinan, PR China.
authors: Jian-dong
authors: JD
authors: Zhang
authors: Department of Radiation Oncology; Shandong Tumor Hospital and Institute; Shandong University; Jinan, PR China.
authors: Xue
authors: X
authors: Meng
authors: Department of Radiation Oncology; Shandong Tumor Hospital and Institute; Shandong University; Jinan, PR China.
authors: Jin-ming
authors: JM
authors: Yu
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm; D066246:ErbB Receptors / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors
keywords: EGFR-TKI; NSCLC; erlotinib; gemcitabine; resistance