オシメルチニブが効果を示した上皮成長因子受容体T790M遺伝子変異陽性小細胞肺癌の1例  [in Japanese] A Case of Small Cell Lung Cancer with an Epidermal Growth Factor Receptor T790M Mutation That Responded to Osimertinib  [in Japanese]

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Abstract

<p><b>背景.</b>近年,小細胞肺癌においても上皮成長因子受容体(epidermal growth factor receptor;EGFR)遺伝子変異陽性症例が散見されるが,EGFR遺伝子変異陽性小細胞肺癌に対するEGFRチロシンキナーゼ阻害薬(tyrosine kinase inhibitor;TKI)の効果は症例により異なる.今回我々はEGFR遺伝子変異陽性小細胞肺癌に対してゲフィチニブ投与後にT790M変異を認め,かつオシメルチニブが効果を示した症例を経験したため報告する.<b>症例.</b>65歳女性,進展型小細胞肺癌(cT2aN0M1b Stage IVB)に一次治療でシスプラチン+エトポシド療法を施行した.増悪時に施行したマルチプレックス遺伝子診断薬による遺伝子解析でEGFR遺伝子変異が陽性であったため,ゲフィチニブを投与したところ,腫瘍の縮小を認めた.しかし3か月で増大したため,血漿検体でEGFR遺伝子変異検査を施行したところT790M変異を認めたためオシメルチニブを投与し,腫瘍の縮小を認めた.<b>結論.</b>EGFR遺伝子変異陽性小細胞肺癌におけるEGFR-TKIは,治療選択肢の一つとなる可能性が示唆された.</p>

<p><b><i>Background. </i></b>Recently, there are few reports of small cell lung cancer with epidermal growth factor receptor (EGFR) gene mutation, but, the efficacy of EGFR tyrosine kinase inhibitor (EGFR-TKI) to small cell lung cancer with EGFR gene mutation has been unknown. Here we report a case of a small cell lung cancer with EGFR mutation T790M after the administration of gefitinib, responded to osimertinib. <b><i>Case. </i></b>A 65-year-old woman was referred to our hospital and diagnosed as small cell lung cancer (cT2aN0M1b cStage IVB) and we performed as first line carboplatin and etoposide for 6 courses, and we screened EGFR mutations using a multiplex gene diagnostic agent which revealed the presence of an Exon21 L858R mutation from the specimens which was first diagnosed. So we administrated gefitinib when the cancer relapsed. It had been effective for about 3 months. Next, we performed EGFR mutation test and found T790M mutation from the plasma specimen, so we tried osimertinib, the cancer responded well. <b><i>Conclusion. </i></b>It was suggested that EGFR-TKI may be one of treatment options of small cell lung cancer with EGFR mutation.</p>

Journal

  • Haigan

    Haigan 59(2), 151-157, 2019

    The Japan Lung Cancer Society

Codes

  • NII Article ID (NAID)
    130007644307
  • Text Lang
    JPN
  • ISSN
    0386-9628
  • Data Source
    J-STAGE 
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