EGFR L858R突变合并EGFR 20外显子插入突变肺腺癌1例报告并文献复习

EGFR L858R Mutation Combined with EGFR Exon 20 Insertion Mutation in Lung Adenocarcinoma: A Case Report and Literature Review

尽管表皮生长因子受体(Epidermal Growth Factor Receptor, EGFR)——酪氨酸激酶抑制剂(tyrosine kinase inhibitor, TKI)极大地改善了EGFR突变患者的疗效及预后,但对于EGFR 20外显子插入突变疗效差,患者生存期短、预后差。本文结合文献回顾报道1例EGFR L858R突变合并EGFR 20外显子插入突变的肺腺癌患者,应用吉非替尼治疗后疗效不佳,接受阿法替尼联合化疗疾病得到良好控制,提示阿法替尼联合化疗对合并EGFR 20外显子插入突变的肺腺癌患者有不错的疗效,为阿法替尼联合化疗治疗EGFR L858R突变合并EGFR 20外显子插入突变的肺腺癌患者提供临床依据。

Although Epidermal Growth Factor Receptor (EGFR)—Tyrosine kinase inhibitor (TKI) has greatly improved the efficacy and prognosis of patients with EGFR mutations, EGFR exon 20 insertion mutation has poor efficacy, short survival and poor prognosis. This article combined literature review to report a case of lung adenocarcinoma with EGFR L858R mutation combined with EGFR exon 20 insertion mutation. Gefitinib was not effective after treatment, and the disease was well controlled after receiving afatinib combined with chemotherapy, suggesting that afatinib combined with chemotherapy has a good effect on lung adenocarcinoma patients with EGFR exon 20 insertion mutation. It provides clinical evidence for afatinib combined with chemotherapy to treat lung adenocarcinoma patients with EGFR L858R mutation and EGFR exon 20 insertion mutation.