Significant Benefits of Afatinib and Apatinib in a Refractory Advanced NSCLC Patient Resistant to Osimertinib: A Case Report

• Main Authors: Zhao Y, Chen Y, Huang H, Li X, Shao L, Ding H
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-05-01
• Series: OncoTargets and Therapy
• Subjects: nsclc; egfr-mutant; tki; afatinib; apatinib
• Online Access: https://www.dovepress.com/significant-benefits-of-afatinib-and-apatinib-in-a-refractory-advanced-peer-reviewed-fulltext-article-OTT

Yuanyang Zhao,1,* Yuxing Chen,1,* Huaying Huang,1 Xi Li,2 Lin Shao,2 Hao Ding1 1Department of Respiratory Disease, Affiliated People’s Hospital of Jiangsu University, Zhenjiang, 212002, People’s Republic of China; 2Department of Medicine, Burning Rock Biotech, Guangzhou, 510300, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hao DingDepartment of Respiratory Disease, Affiliated People’s Hospital of Jiangsu University, No. 8 Dianli Road, Zhenjiang, Jiangsu, 212002, People’s Republic of ChinaTel [phone]Email [e-mail]: EGFR-tyrosine kinase inhibitors (TKIs) have revolutionized the treatment for NSCLC. However, acquired drug resistance often occurs after treatment with EGFR-TKIs. EGFR T790M and C797S mutations are the most common resistance mechanism in patients who failed from first- and third- generation EGFR TKI treatments, respectively. However, there is no standard of care for NSCLC harboring EGFR T790M and C797S in-cis. The present case reports a 69-year-old Chinese man with advanced NSCLC harboring EGFR exon 19-deletion, T790M, cis-C797S, and HER2 amplification who was heavily pre-treated. The patient was then given a combination of afatinib and apatinib and achieved a PFS of more than 10 months. This case showed that afatinib plus apatinib may be a promising therapy for patients with EGFR 19Del-T790M-cis-C797S mutant and HER2 amplified NSCLC.Keywords: NSCLC, EGFR-mutant, TKI, afatinib, apatinib