October 11, 2016


Riess case 1:

A 44-year-old female with relapsed stage IV adenocarcinoma.

  • This is a 44-year-old female diagnosed with stage IV adenocarcinoma
  • Tissue-based mutation testing showed an EGFR mutation with exon 19 deletion
  • She was subsequently treated with afatinib
  • After 11 months she became mildly symptomatic with small, nonspecific pulmonary nodules
  • Follow up CT scan showed growth of the primary lesion
  • The patient reported worsening of her cough
  • Cell-free DNA testing was ordered and was negative for both the EGFR driver mutation and for T790M
  • Subsequent tissue biopsy showed the presence of T790M
  • The patient was switched to osimertinib and continues to respond well to therapy with minimal toxicity