EGFR-mutated lung cancer responds after acquired ROS1 resistance
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Adenocarcinoma
- Biomarkers
- EGFR L858R mutation; acquired ROS1 rearrangement
- Sex
- Female
- Spread to
- pleura
- Treatment
- targeted therapy
- Outcome
- Responding Well
Treatment course, step by step
- She chose afatinib instead of recommended chemoradiation.
- After later progression with pleural spread, treatment changed to osimertinib plus crizotinib.
- The combination produced a sustained response lasting more than 18 months.
What happened, in summary
A 50-year-old woman who had never smoked was diagnosed with Stage III lung adenocarcinoma carrying an EGFR L858R mutation. The cancer involved mediastinal lymph nodes and could not be removed surgically. Chemotherapy and radiation were recommended, but she chose treatment with afatinib instead.
After an initial period of treatment, scans showed worsening disease. By 13 months, the lung mass had grown and cancer had spread to the pleura, with a large pleural effusion and extensive lymph-node involvement. A new biopsy still showed adenocarcinoma. Molecular testing found the original EGFR mutation plus an acquired ROS1 rearrangement.
Her treatment was changed to the targeted drugs osimertinib and crizotinib. Three months later, imaging showed a marked response: the lung tumor was smaller, the pleural fluid and nodules had nearly resolved, and lymph nodes had substantially regressed.
She tolerated the combination well apart from mild liver-test abnormalities. At the latest follow-up, she continued both targeted therapies with a sustained clinical and radiologic response lasting more than 18 months.
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
- Stage 4 Lung Cancer 384 stories
- Stage 4 EGFR Mutation Lung Cancer 74 stories
- EGFR Mutation Lung Cancer 112 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