title: Heterogeneity of the resistance to gefitinib treatment in a non-small cell lung cancer patient with active epidermal growth factor receptor mutation.
abstract: We report the case of a 37-year-old male non-small cell lung cancer patient with an active epidermal growth factor receptor (EGFR) mutation who received gefitinib as first-line treatment. After 13.7 months, the patient experienced disease progression and was treated with platinum-based doublet chemotherapy plus gefitinib for 5.4 months. A subsequent lung biopsy showed cMET overexpression; therefore, the patient received a cMET inhibitor with the gefitinib. The response in the different lesions of several organs was diverse. Stable disease was achieved in the lung lesion; however, the liver metastases enlarged. A liver biopsy found T790M mutation in EGFR exon 20, thus, third generation EGFR-tyrosine kinase inhibitors were used and a partial response was achieved.
authors: Division of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors: Chong-Rui
authors: CR
authors: Xu
authors: Division of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors: Wen-Zhao
authors: WZ
authors: Zhong
authors: Division of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors: Qing
authors: Q
authors: Zhou
authors: Division of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors: Xu-Chao
authors: XC
authors: Zhang
authors: Division of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors: Jin-Ji
authors: JJ
authors: Yang
authors: Division of Pulmonary Oncology, Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China.
authors: Yi-Long
authors: YL
authors: Wu
mesh_terms: D000328:Adult; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics; D019008:Drug Resistance, Neoplasm; D066246:ErbB Receptors / Q000235:genetics*; D000077156:Gefitinib; D018740:Genetic Heterogeneity; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D019859:Proto-Oncogene Proteins c-met / Q000235:genetics*; D011799:Quinazolines / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; C512478:EGFR protein, human; D066246:ErbB Receptors; C491743:MET protein, human; D019859:Proto-Oncogene Proteins c-met; D000077156:Gefitinib
keywords: 
  EGFR
  ; 
  TKI
  ; heterogeneity; lung cancer