Treatment of Metastatic Brain Lesion Using Osimertinib: A Case Report
- Authors: Kazakova S.S.1, Dushina E.V.2
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Affiliations:
- Yas Hospital
- Ryazan State Medical University
- Issue: Vol 30, No 1 (2022)
- Pages: 101-107
- Section: Clinical reports
- URL: https://journals.rcsi.science/pavlovj/article/view/63623
- DOI: https://doi.org/10.17816/PAVLOVJ63623
- ID: 63623
Cite item
Abstract
INTRODUCTION: The article presents clinico-radiological examination data of a female patient with a metastatic brain lesion identified four years after a right upper lobectomy for lung adenocarcinoma. The results of dynamic magnetic resonance imaging (several examinations with intervals from three months to one year) from the onset of the first neurological signs, progression of the disease, to the regression of the pathological focus were analyzed. The molecular genetic study revealed deletion in exon 19 of the EGFR gene and mutation of the Т790M gene. Consequently, osimertinib, a third-generation tyrosine kinase inhibitor with a higher ability to penetrate the hematoencephalic barrier than the first and second generations, was initiated.
CONCLUSION: The presented clinical case demonstrated the positive therapeutic effect of osimertinib on a patient with a metastatic brain lesion identified four years after the right upper lobectomy for lung adenocarcinoma, which was confirmed by a reduction of the volume of the metastatic focus and an absence of contrast accumulation via magnetic resonance imaging.
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##article.viewOnOriginalSite##About the authors
Svetlana S. Kazakova
Yas Hospital
Author for correspondence.
Email: kz-swetlana@yandex.ru
ORCID iD: 0000-0002-8760-2527
SPIN-code: 2234-3604
Cand. Sci. (Med.), Associate Professor
Oman, Al BuraimiEkaterina V. Dushina
Ryazan State Medical University
Email: d.dushin@bk.ru
ORCID iD: 0000-0002-9157-7643
Ассистент кафедры фтизиатрии с курсом лучевой диагностики
Russian Federation, RyazanReferences
- Lee SM, Goo JM, Park CM, et al. A new classification of adenocarcinoma: what the radiologists need to know. Diagnostic and Interventional Radiology. 2012;18(6):519–26. doi: 10.4261/1305-3825.DIR.5778-12.1
- NCCN Clinical practice guidelines in oncology (NCCN guidelines®). Non-Small Cell Lung Cancer. Version 5.2019. Available at: http://tomocenter.com.ua/wp-content/uploads/Non-small-cell-lung-cancer.pdf.
- Planchard D, Popat S, Kerr K, et al. Metastatic non-small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018;29(4):iv192–237. doi: 10.1093/annonc/mdy275
- John T, Akamatsu H, Delmonte A, et al. EGFR mutation analysis for prospective patient selection in AURA3 phase III trial of osimertinib versus platinum–pemetrexed in patients with EGFR T790M–positive advanced non-small-cell lung cancer. Lung Cancer. 2018;126:133–8. doi: 10.1016/j.lungcan.2018.10.027
- Mok TS, Wu Y–L, Ahn M–J, et al. Osimertinib or platinum– pemetrexed in EGFR T790M–positive lung cancer. The New England Journal of Medicine. 2017;376(7):629–40. doi: 10.1056/NEJMoa1612674