Afatinib in clinical practice – patient case study with eighteen months of progression‑free survival and high quality of life

01/2018

MUDr. Jaromír Roubec, Ph.D.^1,2, MUDr. Radoslava Černeková^2,3

1) Plicní oddělení, Vítkovická nemocnice a. s.; Komplexní onkologické centrum, Nový Jičín

2) Klinika plicních nemocí a tuberkulózy, FN Ostrava

3) Komplexní onkologické centrum, FN Ostrava

SUMMARY

The author presents the case report of the patient treated with afatinib. This is a man, the year 1961, in which, on June 3, 2014, a perthoraxal puncture of the left lung bearing under CT control was diagnosed with primary pulmonary adenocarcinoma of the acinaric micropapillary type according to TNM classification T4N3M1b grade IV, with bilateral metastatic lung disease, carcinomatous lymphangiitis, exudate, and metastases to the liver and thyroid. The metastasis of the thyroid gland has been verified punctually and compared to a sample of tissue taken from the lung. Performance status of ECOG 1. Molecular genetic examination on 20 June 2014 detected EGFR activation mutation in L858R exon 21, EGFR gene amplification was detected, ALK and ROS1 gene reconstruction was not found. The patient was only an occasional smoker, the patient visited his physician for weight loss of seven kilograms in three months, and dyspnoea with dry cough. Early treatment with afatinib was initiated on June 27, 2014, less than one month after tissue collection. The patient was on regular monitoring with long-term severe partial regression of lung, liver and thyroid involvement in ECOG 0 performance improvement until disease progression after 18 months of CNS treatment with a total survival of 28 months.

KEY WORDS

non-small cell lung cancer, EGFR activation mutation, first-line treatment