PMC6741769_01
The computed tomography images exhibit a patient with co-existence of EGFR exon 19 deletion and de novo MET amplification shows intrinsic resistance to first-generation EGFR TKI. (A) Baseline assessment before EGFR TKI. (B) The tumor increased and metastasized to both lungs after 3 weeks of icotinib. (C) No improvement in the lesion and lung metastases more than before. (D) The tumor shrunk significantly after 3 weeks of single-agent crizotinib.
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PMC6741769_02_kcbt-20-09-1617568-g001.jpg
F0001
The CT scan of the chest showed that the soft tissue mass in the right lung upper lobe increased and metastatic nodules were found in both lungs (Figure1B). However, after 2 months of icotinib, the CT image of the patient showed no improvement in the lesion and more lung metastases than before (Figure 1C). Three weeks later, repeat chest CT showed the lung mass had significantly shrunk (Figure 1D).
Gene sequencing results of the tumor tissue before treatment.
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Molecular analysis of the tumor tissue by next-generation sequencing (NGS) showed an EGFR exon 19 deletion (c.2253_2276del, p.Ser752_Ile759del) and c-MET gene amplification before treatment (Figure 2).
PMC6741769_02
The computed tomography images exhibit a patient with co-existence of EGFR exon 19 deletion and de novo MET amplification shows intrinsic resistance to first-generation EGFR TKI. (A) Baseline assessment before EGFR TKI. (B) The tumor increased and metastasized to both lungs after 3 weeks of icotinib. (C) No improvement in the lesion and lung metastases more than before. (D) The tumor shrunk significantly after 3 weeks of single-agent crizotinib.
kcbt-20-09-1617568-g001.jpg
PMC6741769_02_kcbt-20-09-1617568-g001.jpg
F0001
The CT scan of the chest showed that the soft tissue mass in the right lung upper lobe increased and metastatic nodules were found in both lungs (Figure1B). However, after 2 months of icotinib, the CT image of the patient showed no improvement in the lesion and more lung metastases than before (Figure 1C). Three weeks later, repeat chest CT showed the lung mass had significantly shrunk (Figure 1D).