机构：[1]Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China河北医科大学第四医院胸二科临床科室[2]Department of Pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China医技科室病理科河北医科大学第四医院
Background: It remains controversial whether patients withEGFR-mutant lung adenocarcinoma should stop using epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) after progression during treatment. Case report: We report a 35-year-old man with poorly differentiated adenocarcinoma of the left upper lobe and anexon 19 deletion (Ex19Del)mutation found by large-panel next-generation sequencing. The patient underwent video-assisted thoracoscopic surgery 12 months after oral administration of icotinib 125 mg tid, and the left upper lobe and surrounding lymph nodes were removed. Postoperative pathology supported a diagnosis of left upper lobe adenocarcinoma and subcarinal (1/2), main pulmonary artery window (1/2), and left hilar (1/2) lymph node metastases. TheEGFRmutations in the residual lesions had disappeared, and Ex19Del mutations were still visible in the mediastinal lymph node metastasis. Conclusion: Spatial heterogeneity of the resistance mechanism may explain why patients who continue to receive EGFR-TKIs in combination with local therapies (e.g., radiotherapy) for progressing lesions may benefit even after progression during EGFR-TKI therapy. The loss of theEGFRmutation allele as a putative resistance mechanism requires additional preclinical and clinical confirmation.
基金：
This project was supported by Medical science research of The
Health Committee of Hebei province.(Grant No.20190681)
第一作者机构：[1]Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China
通讯作者：
通讯机构：[1]Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China[*1]Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, The 12th Jiankang Road, Shijiazhuang, 050000, China.
推荐引用方式(GB/T 7714)：
Xie Shaonan,Deng Huiyan,Liu Guangjie,et al.A case of different gene mutations in primary and metastatic lesions after EGFR-TKI treatment of lung cancer[J].TUMORI JOURNAL.2020,106(6):NP52-NP56.doi:10.1177/0300891620949920.
APA：
Xie, Shaonan,Deng, Huiyan,Liu, Guangjie&Liu, Qingyi.(2020).A case of different gene mutations in primary and metastatic lesions after EGFR-TKI treatment of lung cancer.TUMORI JOURNAL,106,(6)
MLA：
Xie, Shaonan,et al."A case of different gene mutations in primary and metastatic lesions after EGFR-TKI treatment of lung cancer".TUMORI JOURNAL 106..6(2020):NP52-NP56
