Triple positive lung cancer: A case report

Bellala Ravishankar *, D Srikanth, BV Madhavi, Tulika Tyagi, B. Prithvi Raj and B Rishik

Department(s) and institution(s) Omega Hospital, Arilova, Health City, Chinagadili, Visakhapatnam, Andhra Pradesh 530040 India.
 
Review
International Journal of Scientific Research Updates, 2022, 03(01), 029–033.
Article DOI: 10.53430/ijsru.2022.3.1.0023
Publication history: 
Received on 18 December 2021; revised on 24 January 2022; accepted on 26 January 2022
 
Abstract: 
Background: Targeted therapies in nonsmall cell lung cancer has changed the landscape of management and carved the disease in to more different sub types. Despite of considerable initial response to 1st generation and 2nd generation tyrosine kinase inhibitors patients develop resistance in the due course. Secondary mutations are due to threonine and methionine substitution at 790 (T790M) of EGFR. T790M mutation are resistant to 1st and 2nd generation TKI.Osimertinib is a irreversible third generation epidermal growth factor receptor tyrosine kinase inhibitor effective against EGFR T790M mutation positive lung cancer. Patients are inescapable of developing resistance with Osimertinib in spite of initial response and leaving no further definite therapeutic options. In 20-30% patients with osimertinib resistance develop EGFR C797S mutation. Our objective is to show the patient journey with primary, secondary mutation withT790M and tertiary mutation in C797S.
Key Messages: Prospective molecular tumor profiling is now the standard of care in the treatment of metastatic NSCLC. Re-biopsy or liquid biopsy on progression of first and second line TKI to look for T790M has already been in routine practice. Re-biopsy or liquid biopsy on progression of third line TKI and molecular profiling can guide us in further management.
 
Keywords: 
T790M Mutation; Tertiary mutation in Lung cancer; EGFR mutations; Triple positive lung cancer; C797S Mutation
 
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