Gefitinib
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Acquired drug resistance: case report A 37-year-old woman acquired resistance to gefitinib, while being treated for lung adenocarcinoma with bone metastasis. The woman, who had a family history of carcinoma, was diagnosed with osteosarcoma at the age of 11 years. She was treated surgically, and the osteosarcoma was cured. In 2016 (at the age of 37 years), she presented with right shoulder pain. Upon investigation, she was diagnosed with right lung adenocarcinoma with bone metastases. She also had benign thyroid and uterine tumours. The lung adenocarcinoma had EGFR mutations. Treatment was initiated with gefitinib in October 2016 [dosage and route not stated]. The lung adenocarcinoma was controlled for 313-days with partial response. She experienced mild adverse events except grade 3 paronychia [aetiology not specified]. Following one year treatment with gefitinib, right scapula destruction advanced. The bone metastasis turned resistant to gefitinib. A bone biopsy revealed TTF1-, Napsin A- and TP53-positive adenocarcinoma along with acquired resistant mutation T790M. Consequently, the woman’s treatment with gefitinib was switched to osimertinib. She also received radiotherapy and denosumab. Thereafter, primary and bone metastases were under control with osimertinib without any severe adverse events for more than 781 days. Her son was diagnosed with rhabdomyosarcoma and died at 6 years. She was diagnosed to have Li–Fraumeni syndrome. Takahashi S, et al. Lung adenocarcinoma in a patient with Li-Fraumeni syndrome bearing a novel germ-line mutation, TP53R333Vfs*12. Japanese Journal of Clinical 803519426 Oncology 50: 1214-1217, No. 10, Oct 2020. Available from: URL: http://doi.org/10.1093/jjco/hyaa095
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Reactions 5 Dec 2020 No. 1833
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