Alberto P. Romagnolo , Christopher Hino , Saied Mirshahidi , Kristina Chase , Hamid Mirshahidi
{"title":"NCOA-RET fusion as a secondary resistance mechanism to osimertinib in complex EGFR-mutated lung adenocarcinoma: Case report and review of literature","authors":"Alberto P. Romagnolo , Christopher Hino , Saied Mirshahidi , Kristina Chase , Hamid Mirshahidi","doi":"10.1016/j.cpccr.2023.100232","DOIUrl":null,"url":null,"abstract":"<div><p>Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have demonstrated remarkable efficacy for use in advanced non-small-cell lung cancer (NSCLC). However, the inevitable acquisition of resistance mutations to targeted TKI therapy remains the primary cause of treatment failure. We present a case of a patient with EGFR L858R-positive lung adenocarcinoma who developed resistance to erlotinib through EGFR T790M and later developed secondary resistance with HER2 amplification and a rare NCOA4-RET fusion mutation following treatment with osimertinib. Finally, we demonstrate the application of combination therapy with osimertinib with the RET inhibitor, pralsetinib.</p></div>","PeriodicalId":72741,"journal":{"name":"Current problems in cancer. Case reports","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current problems in cancer. Case reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666621923000170","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have demonstrated remarkable efficacy for use in advanced non-small-cell lung cancer (NSCLC). However, the inevitable acquisition of resistance mutations to targeted TKI therapy remains the primary cause of treatment failure. We present a case of a patient with EGFR L858R-positive lung adenocarcinoma who developed resistance to erlotinib through EGFR T790M and later developed secondary resistance with HER2 amplification and a rare NCOA4-RET fusion mutation following treatment with osimertinib. Finally, we demonstrate the application of combination therapy with osimertinib with the RET inhibitor, pralsetinib.