CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2021; 42(02): 204-207
DOI: 10.1055/s-0041-1731851
Case Report with Review of Literature

A Case Report of Primary Resistance to EGFR TKI in Lung Adenocarcinoma Due to Coexisting MET Exon 14 Skipping Mutation with Excellent Response to Combination of Gefitinib and Capmatinib

Nirmal Vivek Raut
1  Department of Oncology, Bhaktivedanta Hospital and Research Institute, Thane (East), Maharashtra, India
,
Siddharth Srivastava
2  Department of Molecular Pathology, Neuberg Supratech, Ahmedabad, Gujarat, India
,
Guarav Dilip Gangwani
3  Department of Radiology, Bhaktivedanta Hospital and Research Institute, Thane (East), Maharashtra, India
,
Heena Sajid Ali
4  Department of Medical Research Department, Bhaktivedanta Hospital and Research Institute, Thane (East), Maharashtra, India
› Author Affiliations
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Abstract

Treatment of nonsmall cell lung cancer (NSCLC) carrying an epidermal growth factor receptor (EGFR) mutation depends on EGFR tyrosine kinase inhibitors (TKIs). However, all patients treated with EGFR TKI eventually develop progressive disease. Approximately, 20% of patients do not respond to EGFR TKIs, which is defined as primary resistance. The prognosis of these patients is similar to NSCLC with nondriver mutations. We report a case of a patient with EGFR exon 21 mutation who rapidly progressed in 15 days on Gefitinib. Next-generation sequencing (NGS) showed a MET exon 14 skip mutation coexisting with EGFR exon 21 mutation, causing primary resistance to EGFR TKI. Based on NGS reports, a treatment combining Gefitinib and Capmatinib, a MET inhibitor, induced a rapid response in the patient, which was sustained at the end of 8 months. This clearly emphasizes the need for comprehensive genomic profiling using NGS over single gene testing.



Publication History

Publication Date:
19 July 2021 (online)

© 2021. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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