内容紹介
A Case of Lung Adenocarcinoma wtih Exon19 and T790M Mutations in EGFR Having Good Response to Erlotinib after Gefitinib Treatment Failure
Summary
A 83-year-old woman was referred to our hospital due to an abnormal shadow in the right lower lung field and pleural effusion on chest X-ray. Cytology of the pleural fluid showed adenocarcinoma. EGFR sequencing showed exon19 and T790M mutations. Gefitinib was prescribed as first-line treatment for stage Ⅳ(pulmonary metastasis)lung adenocarcinoma from March 2011. The response to the treatment was improved pleural effusion and shrunken tumors. She showed recurrence 13 months after administration of gefitinib. Erlotinib was given as second-line treatment from May 2012. She showed good response with shrinkage of the pulmonary metastases, and was alive with no sign of recurrence for 3 months after administration of erlotinib.
要旨
症例は83歳,女性。胸部X線で右下葉に腫瘤陰影と胸水を認めた。胸水細胞診より肺腺癌(Stage Ⅳ多発肺内転移)と診断し,EGFR遺伝子変異はエクソン19欠失変異とT790Mの両者を認めた。2011年3月より初回治療として,ゲフィチニブの投与を行った。胸水の減量と腫瘍マーカーの改善を認め,13か月の投与を行った。その後胸水の増量と肺内転移の増悪を認め,2012年5月からエルロチニブに変更した。変更後,肺内転移の縮小を認め現在も投与継続中である。
目次
Summary
A 83-year-old woman was referred to our hospital due to an abnormal shadow in the right lower lung field and pleural effusion on chest X-ray. Cytology of the pleural fluid showed adenocarcinoma. EGFR sequencing showed exon19 and T790M mutations. Gefitinib was prescribed as first-line treatment for stage Ⅳ(pulmonary metastasis)lung adenocarcinoma from March 2011. The response to the treatment was improved pleural effusion and shrunken tumors. She showed recurrence 13 months after administration of gefitinib. Erlotinib was given as second-line treatment from May 2012. She showed good response with shrinkage of the pulmonary metastases, and was alive with no sign of recurrence for 3 months after administration of erlotinib.
要旨
症例は83歳,女性。胸部X線で右下葉に腫瘤陰影と胸水を認めた。胸水細胞診より肺腺癌(Stage Ⅳ多発肺内転移)と診断し,EGFR遺伝子変異はエクソン19欠失変異とT790Mの両者を認めた。2011年3月より初回治療として,ゲフィチニブの投与を行った。胸水の減量と腫瘍マーカーの改善を認め,13か月の投与を行った。その後胸水の増量と肺内転移の増悪を認め,2012年5月からエルロチニブに変更した。変更後,肺内転移の縮小を認め現在も投与継続中である。