TREATMENT OF ADVANCED NON-SMALL CELL LUNG CANCER FOLLOWING ACQUIRED RESISTANCE TO INITIAL THERAPY WITH OSIMERTINIB

Thị Thái Hòa Nguyễn1,
1 National cancer hospital

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Abstract

Osimertinib is a 3rd generation EGFR Tyrosine Kinase inhibitor that is the preferred treatment for advanced non-small cell lung cancer with EGFR mutations. As the disease progresses, new mutations may appear, the disease may also transform into another histopathological form... Clinically, the disease may progress aggressively or oligo metastatic disease, may develop in the nervous system or outside the central nervous system. So the treatment is very different from case to case. This article reports a case series with the object of describing the clinical, subclinical, modality and treatment results of non-small cell lung cancer cases after osimertinib resistance. In resistant cases, biopsies for the mechanism of resistance are essential, but this is not always possible. Small cell transformation accounts for a very low rate. Etoposide - Platinum chemotherapy is the first choice. If MET amplification mutations are detected, the patient may be suitable for anti-MET therapy. In the absence or knowledge of new resistance mutations, chemotherapy is the primary choice. In cases of Oligo metastasis, local therapy can be combined with continued osimertinib unless the primary mutation is less sensitive to osimertinib.

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References

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