Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2022; 10(17): 5916-5922
Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5916
Response to dacomitinib in advanced non-small-cell lung cancer harboring the rare delE709_T710insD mutation: A case report
Fei Xu, Meng-Ling Xia, Hui-Yun Pan, Jiong-Wei Pan, Yi-Hong Shen
Fei Xu, Meng-Ling Xia, Yi-Hong Shen, Department of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Hui-Yun Pan, Department of Day Care Ward, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
Jiong-Wei Pan, Department of Respiratory Diseases, Lishui City People’s Hospital, Lishui 323000, Zhejiang Province, China
Author contributions: Shen YH initiated the case report and supervised the entire study; Xu F collected patient data, performed a literature review and wrote the manuscript; Xia ML obtained and analyzed the next-generation sequencing results; Pan HY reviewed the histological pathological examination of the biopsy; Pan JW was involved in patient follow-up after discharge; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Hong Shen, MD, Chief Doctor, Department of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310000, Zhejiang Province, China. drsyh@zju.edu.cn
Received: January 22, 2022
Peer-review started: January 22, 2022
First decision: March 16, 2022
Revised: March 21, 2022
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: June 16, 2022
Abstract
BACKGROUND

Tyrosine kinase inhibitors (TKI) have been the standard first-line therapy for advanced non-small cell lung cancer (NSCLC) of epidermal growth factor receptor (EGFR) sensitive mutations. Uncommon EGFR mutations are increasingly reported with the development of next-generation sequencing. However, their sensitivity to TKIs is variable with limited clinical evidence.

CASE SUMMARY

Here, we report a patient with the rare delE709_T710insD mutation, who showed the favorable efficacy of dacomitinib and achieved a partial response with a progression-free survival of 7.0 mo.

CONCLUSION

To our knowledge, this is the first report displaying the clinical efficacy of dacomitinib for patients with delE709_T710insD, which may help to provide alternatives in non-classical variant NSCLC patients. Further studies are warranted to make the optimal choice of EGFR-TKI for rare mutations.

Keywords: Next-generation sequencing, DelE709_T710insD, Non-small-cell lung cancer, Dacomitinib, Uncommon EGFR mutation, Case report

Core Tip: DelE709_T710insD is an extremely rare complex in-frame deletion mutation in exon 18 and accounts for only 0.11% of epidermal growth factor receptor mutations. The development of next-generation sequencing enabled the more identification of rare variants. Our case is the first report describing the clinical efficacy of dacomitinib for delE709_T710insD and achieved a progression-free survival of 7.0 mo. More patients with the rare variants may benefit from dacomitinib targeted therapy based on our study.