Successful treatment of a patient with NSCLC carrying uncommon compound L861Q/G719X epidermal growth factor receptor mutations using Afatinib

The availability of targeted therapies for molecular aberrations have substantially improved the outcomes of advanced non-small-cell lung cancer (NSCLC) patients harboring sensitive mutations. However, patients harboring uncommon epidermal growth factor receptor (EGFR) mutations such as G719X and L861Q often resulted in a lack of response to the first and third generation of EGFR TKIs. In this study, we reported a 64-year-old female patient, who initially presented with symptoms of pneumonia and showed positive response to anti-infection treatment, eventually diagnosed with stage Ⅳ lung adenocarcinoma (LUAD) harboring a rare EGFR G719X and L861Q compound mutations. The patient received 40 mg/day of afatinib and experienced no severe adverse events. As a result, partial response (PR) was observed based on CT scan and a progression free survival of 24 month was achieved. Her follow-up is still ongoing. The results of the present case support the effectiveness and safety of afatinib in LUAD patients carrying EGFR G719X and L861Q compound mutations.