Significant Benefits of Afatinib and Apatinib in a Refractory Advanced NSCLC Patient Resistant to Osimertinib: A Case Report

Onco Targets Ther. 2021 May 7;14:3063-3067. doi: 10.2147/OTT.S300556. eCollection 2021.

Abstract

EGFR-tyrosine kinase inhibitors (TKIs) have revolutionized the treatment for NSCLC. However, acquired drug resistance often occurs after treatment with EGFR-TKIs. EGFR T790M and C797S mutations are the most common resistance mechanism in patients who failed from first- and third- generation EGFR TKI treatments, respectively. However, there is no standard of care for NSCLC harboring EGFR T790M and C797S in-cis. The present case reports a 69-year-old Chinese man with advanced NSCLC harboring EGFR exon 19-deletion, T790M, cis-C797S, and HER2 amplification who was heavily pre-treated. The patient was then given a combination of afatinib and apatinib and achieved a PFS of more than 10 months. This case showed that afatinib plus apatinib may be a promising therapy for patients with EGFR 19Del-T790M-cis-C797S mutant and HER2 amplified NSCLC.

Keywords: EGFR-mutant; NSCLC; TKI; afatinib; apatinib.

Publication types

  • Case Reports

Grant support

This work is funded by Zhenjiang Key Research and Development Program of China (grant NO. SH2018077) and Wu Jieping Medical Foundation (grant NO. 320.6750.19092-38).