Author of

• 20195

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  P3.16 - Surgery (ID 732)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24272

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    P3.16-049 - Surgery with Continued TKI Therapy After Acquiring Resistance to EGFR or ALK TKI (ID 10461)

    09:30 - 09:30  |  Presenting Author(s): Shuta Ohara
    • Abstract

    Background:
    Lung cancer with ALK or EGFR activation inevitably acquires resistance to respective TKIs despite an initial good response. Relapses with only a limited number of regions, so-called oligo-recurrences, occur in a subset of such patients. Here, we present two cases of lung cancer treated with surgery and continued TKI therapy after acquiring resistance to EGFR or ALK TKI.
    
    Method:
    Retrospecive review of patient charts.
    
    Result:
    Case1: A 46-year-old man was diagnosed as having ALK-positive adenocarcinoma with pleural dissemination by exploratory thoracotomy. After 2.5 years’ treatment with alectinib, the primary tumor in the left lower lobe gradually progressed. Left S6 segmentectomy was performed. Genetic analyses of resected specimens revealed ALK G1202R resistant mutation. Alectinib treatment was resumed after surgery and the patient is free of disease 1.5 year after surgery. Case2: A 65-year-old woman presented with lung cancer with ureteral metastasis. Genetic analyses of resected ureteral tumor revealed EGFR L858R point mutation. Gefitinib was initiated and partial response was observed. After 1 year treatment with gefitinib, right middle lobectomy was performed to resect the remaining tumor. Gefitinib treatment was continued and recurrence-free survival of 2 years was achieved.
    
    Conclusion:
    These two patients appear to benefit from surgery and continued TKI therapy after acquiring resistance to EGFR or ALK TKI. It may be one of the treatment strategy in selected patients.