Recurrent Mucinous Lung Cancer With Dose-Dependent Afatinib Responses
This lung cancer diagnosis at a glance
- Subtype
- Adenocarcinoma
- Biomarkers
- SDC4-NRG1 fusion; PD-L1 not expressed; low tumor mutation burden
- Sex
- Female
- Spread to
- bilateral lungs
- Treatment
- surgery, chemotherapy and targeted therapy
- Outcome
- Care Ongoing
Treatment course, step by step
- She underwent right lower-lung surgery and 4 cycles of cisplatin and pemetrexed.
- After cancer returned in both lungs, afatinib produced partial responses.
- A phase I drug held the disease stable for 6 months, followed by ongoing paclitaxel and bevacizumab.
What happened, in summary
A 34-year-old woman who had never smoked was diagnosed with invasive mucinous lung adenocarcinoma after right lower lobectomy in December 2016. The tumor was classified as pT4N2M0. It did not express PD-L1 and had a low tumor mutation burden. She completed 4 cycles of adjuvant cisplatin and pemetrexed.
Nine months after surgery, biopsy confirmed relapse in both lungs. Whole-transcriptome sequencing identified an SDC4-NRG1 fusion. Afatinib began at 40 mg daily in January 2018 and produced a partial response within 6 weeks. Progression appeared after 5 months when the drug level was low. Increasing the dose to 50 mg produced another partial response that lasted until December 2018.
She later entered a phase I trial and had stable disease for 6 months before slow progression. A short afatinib rechallenge did not help after rapid lung progression. Paclitaxel and bevacizumab started in November 2019 and were ongoing at the February 2020 follow-up.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
How we source and attribute stories Accuracy and limitations
Collections this story belongs to
- Metastatic Lung Cancer 25 stories
- Afatinib for Lung Cancer 37 stories
These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer