Case Report: Short-term disease control with subsequent icotinib therapy in EGFR L858R/C797S, T790M-negative lung adenocarcinoma after osimertinib resistance - Scorecard - MDSpire
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Clinical Observation: Temporary Disease Management with Icotinib Following Osimertinib Resistance in Lung Adenocarcinoma with EGFR L858R/C797S and Absence of T790M
Clinical Scorecard: Clinical Observation: Temporary Disease Management with Icotinib Following Osimertinib Resistance in Lung Adenocarcinoma with EGFR L858R/C797S and Absence of T790M
At a Glance
Category
Detail
Condition
Lung Adenocarcinoma with EGFR L858R/C797S Mutation
Key Mechanisms
Resistance to osimertinib due to EGFR C797S mutation without T790M
Target Population
Patients with advanced lung adenocarcinoma harboring specific EGFR mutations
Care Setting
Oncology outpatient care
Key Highlights
71-year-old woman with stage IVB lung adenocarcinoma treated with osimertinib for 29 months
Post-progression ctDNA revealed L858R/C797S mutation without T790M
Subsequent treatment with icotinib achieved stable disease for 6 months
First-generation EGFR-TKIs may provide short-term disease control in C797S/T790M-negative cases
Limited clinical evidence available for treatment strategies in this molecular context
Guideline-Based Recommendations
Diagnosis
Confirm EGFR mutation status using NGS or ctDNA testing
Management
Consider first-generation EGFR-TKIs for patients with C797S/T790M-negative resistance
Monitoring & Follow-up
Regular imaging and ctDNA testing to assess disease progression and treatment response
Risks
Potential for disease progression despite treatment with first-generation EGFR-TKIs
Patient & Prescribing Data
Patients with advanced EGFR-mutant lung adenocarcinoma experiencing osimertinib resistance
Icotinib may offer temporary disease control in specific resistance scenarios
Clinical Best Practices
Monitor for resistance mutations in patients on EGFR-TKI therapy
Evaluate performance status and molecular profile before changing treatment regimens
Consider patient preferences and risks when planning further interventions
