A Patient of Advanced NSCLC with a New EGFR Exon 19 Insertion Mutation and its Response to EGFR-TKIs

J Coll Physicians Surg Pak. 2019 Dec;29(12):S126-S128. doi: 10.29271/jcpsp.2019.12.S126.


Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC) harbouring common EGFR mutations. However, about 10% of EGFR mutations are uncommon mutations and their response to EGFR-TKIs remains unclear. The present case reports a 75-year, female patient with advanced NSCLC, presenting with a new subtype of EGFR exon 19 insertion mutation (IPVAIL insertion), who showed obvious symptom improvement after EGFR-TKIs treatment but a relatively short time of progression-free survival (PFS) and succumbed to tumor 133 days (4.4 months) after diagnosis. In conclusion, patients harbouring new subtype of EGFR exon 19 insertion mutations, IPVAIL insertion may have a poor prognosis. Further experiences are required to characterise these uncommon mutations.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bronchoscopy
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / genetics*
  • DNA, Neoplasm / genetics*
  • ErbB Receptors / drug effects
  • ErbB Receptors / genetics
  • ErbB Receptors / metabolism
  • Exons
  • Fatal Outcome
  • Female
  • Gefitinib / therapeutic use*
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / genetics*
  • Mutagenesis, Insertional / methods
  • Mutation*
  • Positron Emission Tomography Computed Tomography
  • Protein Kinase Inhibitors / therapeutic use


  • DNA, Neoplasm
  • Protein Kinase Inhibitors
  • EGFR protein, human
  • ErbB Receptors
  • Gefitinib