A novel point mutation in exon 20 of EGFR showed sensitivity to erlotinib

• DOI: 10.1007/s12032-014-0036-2
• Publication Date: 2014-06-10T18:45:33Z
• Authors: Kailin Xing; Xiaoyan Zhou; Xinmin Zhao; Si Sun; Zhiguo Luo; Huijie Wang; Hui Yu; Jialei Wang; Jianhua Chang; Xianghua Wu; Aiqun Hu
• Keywords: Male; Lung Neoplasms; Adenocarcinoma of Lung; Antineoplastic Agents; Exons; Adenocarcinoma; Middle Aged; 3. Good health; ErbB Receptors; Erlotinib Hydrochloride; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Amino Acid Substitution; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Quinazolines; Humans; Point Mutation; Molecular Targeted Therapy; Cisplatin; Codon; Protein Kinase Inhibitors

Mutations of epidermal growth factor receptor (EGFR) gene are good predictors of response to treatment with EGFR tyrosine kinase inhibitors (TKIs) for non-small cell lung cancer (NSCLC). It is well established that classic mutations, such as in-frame deletions in exon 19 and the point mutation L858R in exon 21, are associated with high sensitivity to EGFR TKIs. Though mutations in exon 20 are almost correlated with EGFR-TKIs resistance, the awareness that they might confer sensitivity to TKI treatment should be emphasized. Herein, we describe a novel mutation in exon 20 of EGFR in a Chinese male non-smoker, who was diagnosed with stage IV lung adenocarcinoma and characterized by the codon 769 point mutation GTG>GCG, which translates into alanine instead of valine (p.V769A). In this case, the patient showed a good clinical response to erlotinib after paclitaxel/cisplatin first-line and docetaxel second-line chemotherapies. Therefore, we suggest that this rare mutation (p.V769A) may be a sensitive EGFR mutation in NSCLC. The identification of novel EGFR mutations provides new predictive biomarkers for TKI treatment and is essential to the successful use of targeted therapies.