Possibilities of consistent targeted therapy for EGFR-positive NSCLC. Clinical case

Kozlov V.V.; Gulyaeva L.F.

doi:https://doi.org/10.17116/onkolog20198041289

Kozlov V.V.

Sechenov First Moscow State Medical University of Healthcare Ministry of the Russian Federation, Moscow, Russia

Gulyaeva L.F.

Laboratory for Molecular Mechanisms of Carcinogenesis, Research Institute of Molecular Biology and Biophysics, Federal Research Center of Fundamental and Translational Medicine, Federal Agency for Scientific Organizations of the Russian Federation, Novosibirsk, Russia

Possibilities of consistent targeted therapy for EGFR-positive NSCLC. Clinical case

Authors:

Kozlov V.V., Gulyaeva L.F.

More about the authors

Journal: P.A. Herzen Journal of Oncology. 2019;8(4): 289‑294

DOI: 10.17116/onkolog20198041289

Read: 5095 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Kozlov VV, Gulyaeva LF. Possibilities of consistent targeted therapy for EGFR-positive NSCLC. Clinical case. P.A. Herzen Journal of Oncology. 2019;8(4):289‑294. (In Russ.)
https://doi.org/10.17116/onkolog20198041289

Подписка 2026 Онкология. Журнал им. П.А. Герцена (P.A. Herzen Journal of Oncology)

Использование инфографики авторами научных работ

Close metadata

Abstract:

Lung cancer maintains a leading position in the cancer mortality in the world, and in Russia. EGFR tyrosine kinase inhibitors (ITK EGFR) have taken a leading role in the treatment of patients with non-small cell lung cancer (NSCLC) and EGFR mutations. Currently, 3 generations of ICTs EGFR are available in clinical practice. In this regard, coosing the sequence of therapy is becoming increasingly urgent for doctors. We present a clinical case of the possibility of consistent use of TKI inhibitors from the first to the third generation in a patient with EGFR positive NSCLC. The analysis of the course of metastatic NSCLC, which determined the choice of targeted therapy, was made. Methods for overcoming resistance to therapy, its effectiveness and tolerability are considered. As a result of a personalized approach and the consistent use of TKI inhibitors of different generations, in a real clinical case, a total survival of 32 months was achieved, which exceeds the overall survival rates presented in clinical studies.

Keywords:

NSCLC

targeted therapy

EGFR gene

Authors:

Kozlov V.V.

Sechenov First Moscow State Medical University of Healthcare Ministry of the Russian Federation, Moscow, Russia

Gulyaeva L.F.

Close metadata

References:

Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. J Clin. 2014;64(1):9-29. https://doi.org/10.3322/caac.21208
Kaprin AD, Starinskii VV, Petrova GV, eds. Zlokachestvennye novoobrazovaniya v Rossii v 2014 (zabolevaemost’ i smertnost’). Moscow: MNIOI im. P.A. Gertsena filial FGBU «NMIRTs» Minzdrava Rossii, 2016. (In Russ.)
Dannye Form №7 «Svedeniya o zabolevaniyakh ZNO» i №35 'Svedeniya o bol’nykh s ZNO', utverzhdennykh Rosstatom (s izmeneniyami ot 29.12.11) za 2015. (In Russ.)
Arteaga CL. Epidermal growth factor receptor dependence in human tumors: more than just expression? Oncologist. 2002;7(4):31-39. https://doi.org/10.1634/theoncologist.7-2204-31
Yang CH, Yu CJ, Shih JY, Chang YC, Hu FC, Tsai MC, Chen KY, Lin ZZ, Huang CJ, Shun CT, et al. Speciﬁc EGFR mutations predict treatment outcome of stage IIIB/IV patients with chemotherapy-naive non-small-cell lung cancer receiving ﬁrst-line geﬁtinib monotherapy. J Clin Oncol. 2008;26(16):2745-2753. https://doi.org/10.1200/jco.2007.15.6695
Sun S, Schiller JH, Gazdar AF. Lung cancer in never smokers — a different disease. Nat Rev Cancer. 2007;7(10):778-790. https://doi.org/10.1038/nrc2190
Linardou H, Dahabreh IJ, Bafaloukos D, Kosmidis P, Murray S. Somatic EGFR mutations and efficacy of tyrosine kinase inhibitors in NSCLC. Nat Rev Clin Oncol. 2009;6(6):352-366. https://doi.org/10.1038/nrclinonc.2009.62
Maemondo M, Inoue A, Kobayashi K, Sugawara S, Oizumi S, Isobe H, Gemma A, Harada M, Yoshizawa H, Kinoshita I, et al. North-East Japan Study Group. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010;362(25):2380-2388. https://doi.org/10.1056/nejmoa0909530
Yang JC, Wu YL, Schuler M, Sebastian M, Popat S, Yamamoto N, Zhou C, Hu CP, O’Byrne K, Feng J, et al. Afatinib versus cisplatin-based chemotherapy for EGFR mutation-positive lung adenocarcinoma (LUX-Lung 3 and LUX-Lung 6): analysis of overall survival data from two randomised, phase 3 trials. Lancet Oncol. 2015;16(2):141-151. https://doi.org/10.1016/s1470-2045(14)71173-8
Pakzad R, Mohammadian-Hafshejani A, Ghoncheh M, Pakzad I, Salehiniya H. The incidence and mortality of lung cancer and their relationship to development in Asia. Transl Lung Cancer Res. 2015;4(6):763-774. https://doi.org/10.1016/j.prnil.2015.09.001
Shigematsu H, Lin L, Takahashi T, Nomura M, Suzuki M, Wistuba II, Fong KM, Lee H, Toyooka S, Shimizu N, et al. Clinical and biological features associated with epidermal growth factor receptor gene mutations in lung cancers. J Natl Cancer Inst. 2005;97(5):339-346. https://doi.org/10.1093/jnci/dji055
Bollinger MK, Agnew AS, Mascara GP. Osimertinib: A third-generation tyrosine kinase inhibitor for treatment of epidermal growth factor receptor-mutated non-small cell lung cancer with the acquired Thr790Met mutation. J Oncol Pharm Pract. 2018;24(5):379-388. https://doi.org/10.1177/1078155217712401
Maximilian J Hochmair et al. Sequential afatinib and osimertinib in patients with EGFR mutation-positive non-small-cell lung cancer: updated analysis of the observational GioTag study. Future Oncology. 2019 Aug 2. https://doi.org/10.2217/fon-2019-0346