PMC8798167_01
In the figure was reported the clinical evolution of patient's disease in relation to EGFR mutational assessment. From the top to the bottom: (A) thoracic assessment by CT of the disease at diagnosis; (B) molecular characterization at diagnosis of the EGFR exon 19 deletion (p.E746_A750del) and (C) the absence of EGFR exon 20 resistant mutation (p.T790M); (D) thoracic assessment by CT after treatment with gefitinib showed the progression of the disease; (E) molecular evidence of the persistence of the EGFR exon 19 deletion (p.E746_A750del) and (F) the presentation of EGFR exon 20 resistant mutation (p.T790M); (G) thoracic assessment by CT after treatment with osimertinib showed another progression of the disease; (H) molecular evidence of the EGFR exon 19 deletion (p.L747_A750>P) in concomitance (I) with an uncommon EGFR exon 20 point mutation (p.L792Q) without p.T790M.
tcr-08-S1-S64-f1.jpg
PMC8798167_01_tcr-08-S1-S64-f1.jpg
f1
Waltham, Massachusetts, USA). The patient showed the resistance point mutation in EGFR exon 20 (p.T790M) in concomitance with the exon 19 deletion (p.E746_A750del) and underwent a treatment with osimertinib. In May 2017 the patient underwent another liquid biopsy analysis due to the re-presentation of abdominal pain and asthenia. We identified a mutation switch respect to the initial EGFR exon 19 deletion (p.L747_A750>P), and the uncommon point mutation in EGFR exon 20 (p.L792Q), without the evidence of p.T790M (Figure 1).