Stage IV EGFR-mutated lung cancer responds after targeted therapy intolerance
This lung cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Subtype
- Adenocarcinoma
- Biomarkers
- EGFR L858R mutation; PIK3CA E545K mutation; acquired ROS1 rearrangement
- Sex
- Female
- Spread to
- pleura|pericardium|bone|lungs
- Treatment
- targeted therapy, radiation and chemotherapy
- Outcome
- Responding Well
Treatment course, step by step
- She started gefitinib with palliative radiation, then changed to afatinib plus bevacizumab.
- Osimertinib plus crizotinib was later stopped because of side effects.
- She then completed 6 cycles of carboplatin and pemetrexed and continued maintenance pemetrexed.
What happened, in summary
A 55-year-old woman who had never smoked was diagnosed with Stage IV lung adenocarcinoma. Cancer cells were found in pleural and pericardial fluid, and imaging also showed spread to the sternum. Testing identified an EGFR L858R mutation and a PIK3CA mutation.
She first received gefitinib with palliative radiation, then changed to afatinib plus bevacizumab. The cancer initially shrank, but several months later the lung tumor and pleural disease progressed. Repeat molecular testing found an acquired ROS1 rearrangement while the original EGFR mutation remained present.
She then tried osimertinib plus crizotinib, but both drugs had to be stopped quickly because of significant side effects, including an abnormal heart rhythm and severe leg swelling. Her treatment was changed to carboplatin and pemetrexed.
After 6 cycles, imaging showed a partial response across the lung, pleural, pericardial, and lymph-node disease. She then continued maintenance pemetrexed. At the latest follow-up, the partial response had remained sustained for about 7 months after chemotherapy began.
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