A case of multiple primary lung adenocarcinoma with a CD74-NRG1 fusion protein and HER2 mutation benefit from combined target therapy

Thorac Cancer. 2022 Nov;13(21):3063-3067. doi: 10.1111/1759-7714.14636. Epub 2022 Sep 12.

Abstract

Neuregulin 1 (NRG1) gene fusion is a rare oncogenic driver gene in multiple tumor types, leading to the activation of the epidermal growth factor receptor (ErbB)-mediated pathway. Therefore, afatinib, a pan-ErbB family inhibitor, may be a therapeutic candidate for NRG1 fusion-driven tumors. In this case, we report a multiple primary lung adenocarcinoma patient harboring the CD74-NRG1 fusion, epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (ERBB2) mutation simultaneously. The patient received afatinib and pyrotinib combination therapy and showed a significant treatment response with a progression-free survival of 5 months. Our case further supports the use of targeted therapy for NRG1 fusion-positive non-small-cell lung cancer.

Keywords: NRG1 gene fusion; afatinib; lung adenocarcinoma; pyrotinib; targeted therapy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma of Lung*
  • Afatinib / therapeutic use
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Humans
  • Lung Neoplasms* / pathology
  • Mutation
  • Neoplasms, Multiple Primary*
  • Neuregulin-1 / genetics
  • Neuregulin-1 / metabolism
  • Neuregulin-1 / therapeutic use
  • Oncogene Proteins, Fusion / genetics

Substances

  • Neuregulin-1
  • Afatinib
  • Oncogene Proteins, Fusion
  • NRG1 protein, human