Chemotherapy + immunotherapy + anti-vascular therapy and firmonertinib + capmatinib prolong OS in EGFR-mutated and MET amplification following disease progression on osimertinib plus savolitinib: A case report of NSCLC

Backgound

The combination of osimertinib and savolitinib as second-line treatment after epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) resistance can significantly improve median progression-free survival (mPFS), objective response rate (ORR), and duration of remission (DOR). The combination therapy is safe and controllable, with no new safety signals or unexpected toxicity. However, the mechanism of drug resistance for tumor progression after dual-targeted therapy is currently unclear, and there is no clinical data reference for treatment after drug resistance. This case suggests some treatment options for lung adenocarcinoma patient after dual-targeted therapy with osimertinib and savolitinib.

Case presentation

A patient with EGFR-mutated lung adenocarcinoma developed mesenchymal–epithelial transition factor (MET) amplification-related resistance after first-line almonertinib. Subsequent sequential regimens—osimertinib plus savolitinib, chemo-immuno-antiangiogenesis therapy, and finally furmonertinib plus capmatinib—each yielded transient benefit.

Results

The report shows that the combination of chemotherapy and immunotherapy, as well as the dual-targeted therapy of firmonertinib and capmatinib, prolonged the overall survival of the patient.

Conclusions

This case suggests some treatment options for lung adenocarcinoma patient after dual-targeted therapy with osimertinib and savolitinib. The results indicated that traditional treatment or the combination of MET-TKI with another targeted therapy may improve the prognosis of patients.