Ca lâm sàng bệnh nhân ung thư phổi không tế bào nhỏ giai đoạn IV có đột biến EGFR A763-Y764insFQEA exon 20 điều trị thuốc ức chế tyrosin kinase thế hệ 1

EGFR mutations in non-small cell lung cancer (NSCLC) are common with a rate of 40 - 50%, and the most common activating EGFR mutations are in-frame deletions of exon 19 and point mutations of exon 21 (L858R). NSCLC patients with these mutations respond well to EGFR tyrosine kinase inhibitors (TKI)1. Exon 20 insertions are less common and most patients with EGFR exon 20 insertions mutations do not respond to treatment with TKIs. An exception is the A763-Y764insFQEA mutation that is sensitive to treatment with TKIs, with a high rate of response was 62.5% and overall survival was reported up to 22,0 months2. We present a 47-year-old female patient, admitted to the hospital because of cough and chest pain for about 1 month. Computed tomography scan revealed a large mass in the right upper lobe of the lung with right pleural effusion. The patient was diagnosed with stage IV NSCLC (pleural effusion) with EGFR A763-Y764insFQEA mutation on exon 20. She was treated with a 1st generation TKI drug. Currently, after 6 months of treatment, she showed stable disease, clinical symptoms improved significantly and no serious side effects appeared.