Progress of osimertinib in epidermal growth factor receptor mutant non-small cell lung cancer / 肿瘤研究与临床

As an important tumor driver gene, epidermal growth factor receptor (EGFR) gene plays an important role in the development and progression of non-small cell lung cancer (NSCLC). As the latest generation of EGFR-tyrosine kinase inhibitor (TKI) drugs, osimertinib has brought significant therapeutic efficacies and encouraging results both in patients with sensitive EGFR mutations and patients with rare EGFR mutations. Compared with previous EGFR-TKI drugs, osimertinib has strong blood-brain barrier penetration, which can effectively prevent the occurrence of lung cancer brain metastasis. After the resistance of first and second generation of targeted drugs, osimertinib is still effective in the follow-up treatment process. This article reviews the characteristics of EGFR mutation, the action mechanism of osimertinib, and the latest progress of osimertinib in treatment of EGFR mutations in NSCLC.

Efficacy of Immune Checkpoint Inhibitors for Non-small Cell Lung Cancer with Rare Mutation / 中国肺癌杂志

Over the past several decades, advances in driven targeted therapy has revolutionized the management of oncogene-driven non-small cell lung cancer (NSCLC). However, there are only a few targeted drugs available for patients with rare mutations, such as BRAF, HER2, MET, RET, etc. In recent years, immune checkpoint inhibitors (ICIs) have demonstrated promising benefit in NSCLC. Till now, efficacy of ICIs for NSCLC with rare mutation is largely unknown. It is fairly difficult to conduct a large formal prospective controlled trials because of the rarity of these mutation. In this article, currently available real world studies based on convincing clinical evidence will be reviewed, which will ultimately facilitate our rational use of ICIs for NSCLC with rare mutation.
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Non-small cell lung cancer with both EGFR gene L861Q mutation and the first symptom of perforation due to small bowel metastasis: A case report / 肿瘤

Objective: To explore the treatment strategy for non-small cell lung cancer patients with both rare mutation (L861Q) of epidermal growth factor receptor (EGFR) gene and the first symptom of perforation due to small bowel metastasis. Methods: The medical records as well as the diagnosis and treatment process of a case of non-small cell lung cancer with both rare EGFR mutation and the first symptom of perforation due to small bowel metastasis were reviewed restropectively, to explore the treatment strategy. Results: The perforation was the first symptom in this non-small cell lung cancer patient with both rare EGFR mutation (L861Q) and small bowel metastasis. After the laparotomy and partial small intestine resection, afatinib was administered orally for 16 days according to the genetic test results until peritoneal effusion and enlarged lesions in the right lung was found, as well as liver, bilateral adrenal, brain parenchymal, vertebral and retroperitoneal lymph node metastases were assessed by CT and MR scan. Progressive disease with eventual death of vomiting occured, and the rescue is invalid. The overall survival time was 110 days after surgery. Conclusion: For non-small cell lung cancer patients with both rare EGFR mutation (L861Q) and small bowel metastasis, the prompt diagnosis and treatment against primary tumor are the keys to improve their prognosis. Rare EGFR mutations are heterogeneous and lack of standard treatment due to the low incidence. Further large-scale prospective randomized controlled studies are needed.