Metachronous development of L858R and T790M EGFR mutations following ALK inhibitor therapy in stage IV lung adenocarcinoma: a case report.

ABSTRACT:

Background

Metachronous lung cancers with distinct driver mutations are rare, particularly following targeted therapy. This report presents a unique case of tumor evolution in non-small cell lung cancer (NSCLC).

Case description

A 73-year-old East Asian woman was diagnosed with stage IV anaplastic lymphoma kinase (ALK)-rearranged lung adenocarcinoma in the right middle lobe (RML). After 18 months of alectinib treatment, while the initial lesion regressed, a new nodule developed in the right upper lobe (RUL). Biopsy revealed adenocarcinoma with epidermal growth factor receptor (EGFR) L858R/T790M co-mutations without ALK rearrangement. We conducted a comparative analysis of genetic alterations in biopsies from 2022 and 2024 using targeted next-generation sequencing (NGS), reve

SUBMITTER: Kim SY 

PROVIDER: S-EPMC12000955 | biostudies-literature | 2025 Mar

REPOSITORIES: biostudies-literature