Stage IV EGFR-Mutant Lung Adenocarcinoma Responding to Osimertinib

This lung cancer diagnosis at a glance

Stage at diagnosis
Stage IV
Subtype
Adenocarcinoma
Biomarkers
EGFR L833V/H835L mutations; PD-L1 50%; CDK4 amplification; MDM2 amplification
Sex
female
Spread to
contralateral lung, brain
Treatment
targeted therapy
Outcome
Responding Well

Treatment course, step by step

  1. Started osimertinib for EGFR-mutant Stage IV lung adenocarcinoma.
  2. The dose was reduced after diarrhea and rash developed.
  3. Continued osimertinib with radiographic response.

What happened, in summary

A 75-year-old woman developed a persistent dry cough. Imaging in July 2023 found a right upper-lung mass, right hilar lymph-node enlargement and abnormal areas in the left lung. Biopsies from both lungs confirmed adenocarcinoma. Brain MRI also found a metastasis in the right parietal lobe, establishing Stage IV disease.

Tumor testing identified the rare EGFR L833V and H835L mutations. PD-L1 expression was 50%, and CDK4 and MDM2 amplifications were also reported. Because systemic treatment was expected to address both the lung and brain disease, she started osimertinib rather than local brain radiation.

The initial osimertinib dose caused diarrhea and rash, so it was reduced. After 3 months, PET imaging showed a clear response: the right upper-lung lesion was smaller and the right hilar lymph-node enlargement had completely resolved. Repeat brain MRIs showed that the brain metastasis remained stable. A chest X-ray in May 2024 showed continued improvement in the lung lesion.

She remained on osimertinib with an ongoing response to treatment.

Where this story comes from

This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full

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