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Osimertinib (AZD9291) and CNS Response in Two Radiotherapy-Naïve Patients with EGFR-Mutant and T790M-Positive Advanced Non-Small Cell Lung Cancer

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Abstract

The discovery of sensitizing epidermal growth factor receptor (EGFR) mutations as a predictive marker of sensitivity to first-generation EGFR tyrosine kinase inhibitors (TKIs) has dramatically changed the paradigm of care for advanced non-small cell lung cancer (NSCLC) patients. Unfortunately, the majority of patients with EGFR-mutant NSCLC treated with EGFR–TKIs develop acquired resistance within 14–16 months. T790M mutation recently emerged as a major determinant of acquired resistance to gefitinib and erlotinib. Osimertinib (AZD9291) is a novel mono-anilino-pyrimidine third-generation EGFR TKI targeting both sensitizing and T790M EGFR-mutation which showed promising results in T790M-positive NSCLC. Here we report two cases of gefitinib- or erlotinib-pretreated NSCLCs with a T790M mutation-positive (as assessed on plasma through the therascreen EGFR test) disease and untreated, asymptomatic central nervous system metastases that responded to treatment with osimertinib.

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Correspondence to Biagio Ricciuti.

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The authors have no sources of funding to disclose.

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Biagio Ricciuti, Rita Chiari, Pietro Chiarini, Lucio Crinò, Daniele Maiettini, Vienna Ludovini, and Giulio Metro declare that they have no conflicts of interest.

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Written informed consent was obtained from the patients involved in this study for both inclusion in the clinical trial NCT02474355 and publication of their cases.

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Ricciuti, B., Chiari, R., Chiarini, P. et al. Osimertinib (AZD9291) and CNS Response in Two Radiotherapy-Naïve Patients with EGFR-Mutant and T790M-Positive Advanced Non-Small Cell Lung Cancer. Clin Drug Investig 36, 683–686 (2016). https://doi.org/10.1007/s40261-016-0411-1

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  • DOI: https://doi.org/10.1007/s40261-016-0411-1

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