Updated phase 2 data showed a 60% ORR and 86% CNS ORR with frontline silevertinib in non-classical EGFR-mutant NSCLC; FDA discussion supported a phase 3 trial in 2027.
|Videos|February 20, 2020
A 64-Year-Old Male with Untreated Stage IV EGFR-Mutated NSCLC
A 64-Year-Old Male with Untreated Stage IV EGFR-Mutated NSCLC
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Case: A 64-Year-Old Male with Untreated Stage IVEGFRMutated NSCLC
Initial presentation
- A 64-yearold man presented with shortness of breath, productive cough, chest pain, fatigue, anorexia and an 8-lb weight loss.
- PMH: HTN, medically controlled
- SH: non-smoker, social alcohol use
- PE: tired-appearing man, decreased breath sounds on auscultation
Clinical workup
- Imaging:
- Chest x-ray showed a left lower lobe mass
- Chest/abdomen/pelvic CT scan confirmed a node extension, a 4.7-cm left lower lobe mass with mediastinal and hilar lymphadenopathy; left-sided adrenal metastases noted
- PET scan showed activity in the left lower lobe mass and hilar nodal areas
- Brain MRI showed no evidence of metastases
- Staging: T3N3M1a - IVA adenocarcinoma; ECOG PS 1
- Bronchoscopy with transbronchial biopsy of the left lower lobe was minimal and insufficient, subsequent plasma testing showedEGFRexon 19 deletion mutation
Treatment
- Patient was started on osimertinib 80 mg PO qDay
- At 3-week follow-up the patient had been tolerating treatment well; continued on therapy
- Repeat Imaging at 3 months showed partial response
- Follow-up at 6 and 9 months showed stable disease
- At 18-months, CT scan revealed a new solitary liver lesion
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