Response to osimertinib in a colorectal cancer patient with an EGFR T790M mutation: A case report
BACKGROUNDAlthough common in lung cancer, somatic epidermal growth factor receptor (EGFR) mutations are rarely found in colorectal cancer, occurring in approximately 3% of cases. Treatment with anti-EGFR antibodies is commonplace, but EGFR tyrosine kinase inhibitors are not standard treatments in co...
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Veröffentlicht in: | World journal of gastrointestinal oncology 2023, Vol.15 (10), p.1829-1834 |
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Hauptverfasser: | , , , , , , |
Format: | Report |
Sprache: | eng |
Online-Zugang: | Volltext |
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Zusammenfassung: | BACKGROUNDAlthough common in lung cancer, somatic epidermal growth factor receptor (EGFR) mutations are rarely found in colorectal cancer, occurring in approximately 3% of cases. Treatment with anti-EGFR antibodies is commonplace, but EGFR tyrosine kinase inhibitors are not standard treatments in colorectal cancer. Here we report a case of sustained response to osimertinib in a colorectal cancer patient with an EGFR T790M mutation on cell-free DNA analysis.CASE SUMMARYA 72-year old woman with a past medical history of post-polio syndrome confined to a wheelchair, scoliosis and hypothyroidism presented with metastatic sigmoid colon adenocarcinoma with hepatic metastases. Next generation sequencing revealed a RAS/RAF wild-type, microsatellite stable, PD-L1 negative malignancy. Mutations in TP3 and APC were also identified, as well as EGFR amplification. Cell-free DNA analysis revealed an EGFR T790M mutation. She was unable to tolerate first-line treatment with panitumumab, 5-fluorouracil and leucovorin, progressed on second-line treatment with trifluridine/tipiracil plus bevacizumab, and was unable to tolerate third-line treatment with regorafenib. She was started on fourth-line treatment with off-label osimertinib, with clinical response - decrease in size of hepatic metastases and a pericardial effusion. She remained on treatment with osimertinib for seven months.CONCLUSIONThis case shows the benefit of multi-gene sequencing assays to identify potential therapeutic options in patients with refractory disease. |
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ISSN: | 1948-5204 1948-5204 |
DOI: | 10.4251/wjgo.v15.i10.1829 |