Exceptional response to Erlotinib monotherapy in EGFR Exon 19-deleted, KRAS wild-type, Chemo-refractory advanced pancreatic adenocarcinoma

Robin Park; Mohammed Al-Jumayli; Kirk Miller; Azhar Saeed; Anwaar Saeed

doi:10.1016/j.ctarc.2021.100342

Exceptional response to Erlotinib monotherapy in EGFR Exon 19-deleted, KRAS wild-type, Chemo-refractory advanced pancreatic adenocarcinoma

Cancer Treat Res Commun. 2021:27:100342. doi: 10.1016/j.ctarc.2021.100342. Epub 2021 Feb 17.

Authors

Robin Park¹, Mohammed Al-Jumayli², Kirk Miller³, Azhar Saeed⁴, Anwaar Saeed⁵

Affiliations

¹ MetroWest Medical Center/Tufts University School of Medicine, Framingham, MA, United States.
² Department of Medicine, Division of Medical Oncology, Kansas University Cancer Center, Kansas City, Kansas, United States.
³ Department of Radiology, Kansas University Medical Center, Kansas City, Kansas, United States.
⁴ Department of Pathology and Laboratory Medicine, Kansas University Medical Center, Kansas City, Kansas, United States.
⁵ Department of Medicine, Division of Medical Oncology, Kansas University Cancer Center, Kansas City, Kansas, United States. Electronic address: [email protected].

PMID: 33611092
DOI: 10.1016/j.ctarc.2021.100342

Abstract

Advanced pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive tumor with an abysmal prognosis. Beyond the first-line setting, treatment for advanced PDAC is limited and suboptimal. Also, the efficacy of epidermal growth factor receptor (EGFR) targeted therapy alone in the chemo-refractory setting in PDAC tumors harboring druggable EGFR mutations is unclear. Here we describe the case of a patient with chemo-refractory advanced PDAC with an activating exon-19 EGFR mutation who had an exceptional response to erlotinib monotherapy.

Keywords: Epidermal growth factor receptor; Exon-19 mutation; Pancreatic adenocarcinoma.

Publication types

Case Reports

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / pharmacology
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Camptothecin / analogs & derivatives
Camptothecin / pharmacology
Camptothecin / therapeutic use
Carcinoma, Pancreatic Ductal / diagnosis
Carcinoma, Pancreatic Ductal / drug therapy*
Carcinoma, Pancreatic Ductal / genetics
Carcinoma, Pancreatic Ductal / pathology
Drug Resistance, Neoplasm / genetics
ErbB Receptors / antagonists & inhibitors
ErbB Receptors / genetics
Erlotinib Hydrochloride / pharmacology
Erlotinib Hydrochloride / therapeutic use*
Exons
Female
Fluorouracil / pharmacology
Fluorouracil / therapeutic use
Humans
Leucovorin / pharmacology
Leucovorin / therapeutic use
Middle Aged
Mutation
Neoplasm Staging
Pancreatic Neoplasms / diagnosis
Pancreatic Neoplasms / drug therapy*
Pancreatic Neoplasms / genetics
Pancreatic Neoplasms / pathology
Proto-Oncogene Proteins p21(ras) / genetics
Treatment Outcome

Substances

KRAS protein, human
Erlotinib Hydrochloride
EGFR protein, human
ErbB Receptors
Proto-Oncogene Proteins p21(ras)
Leucovorin
Fluorouracil
Camptothecin

Supplementary concepts

IFL protocol