PMC8059409_01
The LUAD patient harboring canonical EGFR-KDD involving exons 18-25. (A) Visualization of canonical EGFR-KDD using the Integrative Genomics Viewer (IGV) browser. The dashed lines indicate the genomic breakpoints. (B) The genetic and protein domain structures of EGFR-KDD. EGFR/EGFR, epidermal growth factor receptor; KDD, kinase domain duplication; LUAD, lung adenocarcinoma; Recep L, Receptor L domain; Furin-like, Furin-like cysteine rich region; GF recep IV, Growth factor receptor domain IV; KD, tyrosine kinase domain.
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F1
Capture-based targeted sequencing (Burning Rock Biotech, Guangzhou, China) was performed on the primary tumor sample, which revealed canonical EGFR-KDD involving exons 18-25 (Figure 1) and negative for well-known actionable alterations occurring in EGFR.
A summary of the treatment procedure of the patient. (A) The entire treatment procedure. LUAD, lung adenocarcinoma; PR, partial response; NGS, next-generation sequencing; EGFR, human epidermal growth factor receptor 2; KDD, kinase domain duplication; CT, computed tomography; PD-L1, programmed death ligand-1. (B) Chest CT imaging of the LUAD patient prior to afatinib treatment, 1 month after the treatment, and 7 months after the treatment. The yellow arrows indicate the lesions. LUAD, lung adenocarcinoma; CT, computed tomography.
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Figure 2A illustrated the treatment procedure of the patient. The patient achieved partial response (PR) with significant shrinkage of the tumor, from a diameter of 17 mm to 11 mm 1 month after afatinib treatment and it further reduced to 6 mm at 7 months (Figure 2B).