Conversion from Positive to Negative EGFR Mutation due to Clonal Selection during Long-Term Treatment with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors: A Case Report

Case Reports in Oncology

Wataru Okamoto¹  Kazuhiko Sugiyama²  Kentaro Tokumo²  Masami Yamauchi²  Masashi Namba²  Noboru Hattori³  Tadashi Senoo⁴  Masatomo Ueda⁵ 

[1] Cancer Treatment Center, Hiroshima University Hospital, Hiroshima, Japan;Department of Clinical Oncology, Hiroshima University Hospital, Hiroshima, Japan;Department of Respiratory Medicine, Hiroshima University Hospital, Hiroshima, Japan;Department of Respiratory Medicine, National Hospital Organization, Kure Medical Center, Hiroshima, Japan;Postgraduate Clinical Training Center, Hiroshima University Hospital, Hiroshima, Japan;

关键词: epidermal growth factor receptor mutation;    gefitinib;    erlotinib;    non-small cell lung cancer;    mechanisms of resistance;   

DOI  :  10.1159/000518246

来源: DOAJ

【 摘 要 】

A 77-year-old woman with postoperative recurrent non-small cell lung adenocarcinoma, which exhibited an epidermal growth factor receptor (EGFR) L858R mutation, was treated with gefitinib and erlotinib. Seven years after the start of treatment, the patient experienced a recurrence of malignant pleural effusion. However, 3 different genetic tests revealed that the lung adenocarcinoma cells in the pleural effusion had lost EGFR L858R mutation, suggesting that long-term treatment with EGFR-tyrosine kinase inhibitors (TKIs) converted EGFR mutation from positive to negative. The negative conversion of EGFR mutation as a mechanism of acquired resistance to EGFR-TKIs is considered rare and needs to be further investigated.

【 授权许可】

Unknown