Complete Response to Afatinib of an EGFR Exon 18 delE709_T710insD-Mutated Stage IV Lung Adenocarcinoma
  • Blandine Jelli
    Department of Pulmonology, Hôpital Erasme, Brussels, Belgium https://orcid.org/0000-0002-2601-4166
  • Olivier Taton
    Department of Pulmonology, Hôpital Erasme, Brussels, Belgium
  • Nicky D'Haene
    Department of Pathology, Hôpital Erasme, Brussels, Belgium
  • Myriam Remmelink
    Department of Pathology, Hôpital Erasme, Brussels, Belgium
  • Zita Mekinda
    Department of Pulmonology, Hôpital Erasme, Brussels, Belgium

Keywords

EGFR mutation, exon 18, delE709_T710insD, lung cancer, afatinib

Abstract

Introduction: Epidermal growth factor receptor (EGFR) mutations are frequently found in patients with lung adenocarcinomas, 90% being deletions in exon 19 or point mutation in exon 21. Three generations of tyrosine kinase inhibitors (TKIs) targeting EGFR mutations are available and have changed patient prognosis but less data is available on exon 18 mutations and their sensitivity to TKI therapy. Exon 18 delE709_T710insD accounts for 0.06% (16/27,294) of all EGFR mutations and is an oncogenic driver. Several partial responses to afatinib have been described.

Case description: We report the first case, to the best of our knowledge, of the complete response to afatinib of a 57-year-old patient with stage IV lung adenocarcinoma with a delE709_T710insD mutation in the EGFR gene detected by next-generation sequencing. Oral afatinib was prescribed and despite treatment interruptions and dosage tapering due to cutaneous adverse events, a complete response was achieved 12 months after treatment initiation and is currently maintained at 17 months.

Conclusion: When EGFR mutation is suspected, complete DNA sequencing of exons 18 to 21 should be carried out and we suggest that afatinib should be the first-line treatment for exon 18 delE709_T710insD-mutated advanced lung adenocarcinomas.

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    Published: 2021-08-11
    Issue: 2021: Vol 8 No 8 (view)

    How to cite:
    1.
    Jelli B, Taton O, D’Haene N, Remmelink M, Mekinda Z. Complete Response to Afatinib of an EGFR Exon 18 delE709_T710insD-Mutated Stage IV Lung Adenocarcinoma. EJCRIM 2021;8 doi:10.12890/2021_002749.