A rare EGFR exon 19 insertion mutation in metastatic lung adenocarcinoma: a favorable response to afatinib

Anticancer Drugs. 2025 Feb 1;36(2):151-153. doi: 10.1097/CAD.0000000000001671. Epub 2024 Dec 24.

Abstract

Epidermal growth factor receptor (EGFR) mutations like the common L858R and exon 19 deletions are well studied, but rarer mutations like exon 19 insertions have received less attention. This case report describes a patient with this uncommon EGFR exon 19 insertion mutation in metastatic lung adenocarcinoma. A 51-year-old male nonsmoker with metastatic lung adenocarcinoma and a rare EGFR exon 19 insertion mutation experienced disease progression on initial carboplatin-pemetrexed chemotherapy. However, treatment with the second-generation tyrosine kinase inhibitor afatinib led to a partial response, with significant regression of the primary tumor and bone metastases. This case highlights the favorable clinical response to afatinib treatment in a patient with metastatic nonsmall cell lung cancer harboring a rare EGFR exon 19 insertion mutation.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology
  • Adenocarcinoma of Lung* / drug therapy
  • Adenocarcinoma of Lung* / genetics
  • Adenocarcinoma of Lung* / pathology
  • Afatinib* / therapeutic use
  • ErbB Receptors* / genetics
  • Exons*
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / pathology
  • Male
  • Middle Aged
  • Mutagenesis, Insertional
  • Mutation
  • Protein Kinase Inhibitors / therapeutic use
  • Quinazolines* / therapeutic use

Substances

  • Afatinib
  • ErbB Receptors
  • EGFR protein, human
  • Quinazolines
  • Protein Kinase Inhibitors