Durable Response to Immune Checkpoint Blockade Plus Albumin-Bound Paclitaxel in Two Osimertinib-Refractory Patients with EGFR-mutated Lung Adenocarcinoma

Abstract

Osimertinib (AZD9291, Tagrisso) is an irreversible third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) compound. Limited effective therapeutic regimens are recommended for patients who progress with osimertinib. We retrospectively reviewed two patients with EGFR mutations who were resistant to osimertinib and received anti-programmed cell death-1 (anti-PD-1) agents combined with Abraxane with stage IV cancer. The two patients (one male and one female) were diagnosed with EGFR mutation-positive advanced lung adenocarcinoma and received first- or second-generation EGFR-TKIs. When these patients became resistant, both received osimertinib. Both patients had disease progression after osimertinib and received combination therapy of immune checkpoint blockade (nivolumab or pembrolizumab) and albumin-bound paclitaxel (Abraxane). These patients achieved partial remission (PR), and their progression-free survival (PFS) were respectively 8.0 months and 10.0 months. The combination of immunotherapy and Abraxane could be an effective option for the treatment of patients resistant to osimertinib.