Author:
Sahrun Sahrun,Wulandari Laksmi
Abstract
Various tyrosine kinase inhibitor (TKI) drugs have been widely used as therapy for cancer that has EGFR mutations, or abnormal EGFR activation. However, patients who have a mutation in the gene that activates EGFR only benefit from EGFR-TKI therapy for less than one year, because after that resistance occurs. In the management of patients according to NCCN 2017, patients who experience progress after receiving TKI as the first-line therapy must undergo an examination to identify the presence of T790M mutation. If the T790M mutation is positive, the choice of therapy that needs to be provided is the third generation (Osimertinib). Many recent studies have proved the significance of the effectiveness and response of Osimertinib therapy in lung cancer with EGFR T790M mutation. We reported the management of a pulmonary adenocarcinoma patient with positive EGFR mutation who had received first-line EGFR TKI who had progressive disease and T790M mutation in Dr. Seotomo Hospital. The patient finally received Osimertinib through an Early Access Program with a therapeutic response that improved significantly.
Reference25 articles.
1. Arief N (2009). Kegawatdaruratan paru, departemen pulmonologi dan ilmu kedokteran respirasi FKUI RS PERSAHABATAN, Universitas Indonesia
2. Blom JW, Doggen CJ, Osanto S, et al (2005). Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 293, 715-722. Available from https://www.ncbi.nlm.nih. gov/pubmed/157019 13. Accessed September 13, 2018
3. Superior vena cava syndrome in a patient with small-cell lung cancer: A case report;Brzezniak;Case Rep Oncol,2017
4. The clinical course of pulmonary embolism;Carson;N Engl J Med 326 p 1240-1245 Available from https,1992
5. EGFR Antagonists in Cancer Treatment;Ciardiello;N Engl J Med,2008