title: Getting out of a wheelchair: an uncommon insertion mutation in exon 19 of EGFR responsive to erlotinib.
abstract: BACKGROUND
  Most patients with non-small cell lung cancer (NSCLC) present with advanced disease and have poor long-term prognosis. Advanced NSCLC that contains characteristic mutations in epidermal growth factor receptor (EGFR) are highly sensitive to EGFR tyrosine kinase inhibitors (TKIs). EGFR exon 19 insertions mutations are rare, and response to TKIs is still unclear.
  
  
  METHODS
  A young Arab patient was diagnosed with metastatic disease of NSCLC harboring an exon 19 insertion of 18 nucleotides. The patient showed a very impressive clinical and radiological response within few weeks treatment with TKI agent.
  
  
  RESULTS
  To our best knowledge, This case is the first case in Arab woman and one of few cases described in the literature with this rare mutation responding to TKIs.
  
  
  CONCLUSIONS
  Treatment with TKIs should be the standard choice in patients with metastatic disease NSCLC.
authors.affiliation: Division of Oncology, Rambam Health Care Campus, POB 9602, Haifa, 31096 Israel.
authors.forename: Abed
authors.initials: A
authors.lastname: Agbarya
authors.affiliation: Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Meira
authors.initials: M
authors.lastname: Melamed-Frank
authors.affiliation: Division of Oncology, Rambam Health Care Campus, POB 9602, Haifa, 31096 Israel.
authors.forename: Orit
authors.initials: O
authors.lastname: Kaidar-Person
authors.affiliation: Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Ilana
authors.initials: I
authors.lastname: Goldberg-Cohen
authors.affiliation: Division of Oncology, Rambam Health Care Campus, POB 9602, Haifa, 31096 Israel.
authors.forename: Haitam
authors.initials: H
authors.lastname: Nasrallah
authors.affiliation: Division of Oncology, Rambam Health Care Campus, POB 9602, Haifa, 31096 Israel.
authors.forename: Mira
authors.initials: M
authors.lastname: Wollner
authors.affiliation: Oncology Institute, Tel Hashomer Medical Center, Tel Aviv, Israel.
authors.forename: Jair
authors.initials: J
authors.lastname: Bar
authors.affiliation: Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Gad
authors.initials: G
authors.lastname: Rennert
authors.affiliation: Carmel Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Flavio
authors.initials: F
authors.lastname: Lejbkowicz
keywords: Epidermal growth factor receptor; Erlotinib; Exon 19 insertion; Non-small cell lung cancer