Osimertinib and chemotherapy combination to treat brain metastasis flare and osimertinib resistance by EGFR C797S

Abstract

Chemotherapy or involvement in a clinical trial remain the standard treatment for patients with EGFR mutant non-small cell lung cancer who have disease progression while receiving Osimertinib. Rapid progression, also known as flare-phenomenon, has been described after discontinuation of tyrosine kinase inhibitors. In this case, we describe a young woman who has extracranial progressive disease due to EGFR C797S resistance mutation while being treated with osimertinib, with a rapid neurological deterioration after osimertinib withdrawal due to flare-phenomenon progression in the brain, and a prompt intracranial response with osimertinib reintroduction in addition to chemotherapy to achieve extracranial diseases control.

Keywords:

• Flare-phenomenon
• EGFR
• combined treatment
• cell dormancy
• clone resistance
• NSCLC

Conflicts of interest

Dr. Juan Blaquier reports educational grants from Amgen, Dr. Gonzalo Recondo reports grants from Amgen, personal fees from Roche, Bayer, BMS, MSD, Pfizer, Takeda, and Amgen.

Disclosure statement

No potential conflict of interest was reported by the authors.