In a live virtual event, Yasir Y. Elamin, MD, discussed biomarker testing and management of non–small cell lung cancer (NSCLC) and a related patient case with participating physicians.
CASE SUMMARY
A 66-year-old man presented to his primary care physician complaining of visual disturbances, fatigue, and sporadic headaches. He had a medical history of hypertension managed with candesartan and hyperlipidemia managed with simvastatin in addition to a smoking history of 25 pack-years. A physical examination showed blood pressure level at 148/70 mm Hg and decreased breath sounds in the lower left lobe, but it showed an otherwise negative result for disease. Complete blood count and chemistry results were within normal limits.
A brain MRI scan demonstrated a 10-mm right parietal mass at the gray-white junction without significant vasogenic edema. A CT scan of the chest, abdomen, and pelvis revealed a 3.4-cm mass in the lower left lobe and several small liver metastases. Ultrasound-guided transthoracic needle biopsy result of the lung lesion showed grade 2 lung acinar adenocarcinoma. Staging was T2aN0M1c, and his ECOG performance status was 1. The patient had 90% PD-L1 expression on tumor cells (22C3 pharmDx test) and was anxious to start treatment.
CASE UPDATE
Molecular panel testing result: EGFR exon 19 deletion
CASE UPDATE
The patient received stereotactic radiosurgery while awaiting molecular studies. Osimertinib 80 mg once daily was initiated. He experienced a good partial response.
Roundtable Wrap-Upa
In this Case-Based Roundtable event on advanced metastatic NSCLC, Eamin covered important topics in the field, including the following:
a This content was generated in tandem with artificial intelligence.
REFERENCES
Hess LM, Krein PM, Haldane D, Han Y, Sireci AN. Biomarker testing for patients with advanced/ metastatic nonsquamous NSCLC in the United States of America, 2015 to 2021. JTO Clin Res Rep. 2022;3(6):100336. doi:10.1016/j.jtocrr.2022.100336
2. Sadik H, Pritchard D, Keeling DM, et al. Impact of clinical practice gaps on the implementation of personalized medicine in advanced non-small-cell lung cancer. JCO Precis Oncol. 2022;6:e2200246. doi:10.1200/PO.22.00246
3. NCCN. Clinical Practice Guidelines in Oncology. Non-small cell lung cancer, version 3.2023. Accessed September 5, 2023. https://bit.ly/3P4vyU6
4. Ramalingam SS, Vansteenkiste J, Planchard D, et al; FLAURA Investigators. Overall survival with osimertinib in untreated, EGFR-mutated advanced NSCLC. N Engl J Med. 2020;382(1):41-50. doi:10.1056/NEJMoa1913662
5. Ramalingam SS, Zhang N, Yu J, et al. Real-world landscape of EGFR C797X mutation as a resistance mechanism to osimertinib in NSCLC. Presented at: International Association for the Study of Lung Cancer 2022 World Conference on Lung Cancer; August 6-9, 2022; Vienna, Austria. Abstract OA03.05.
6. FDA grants accelerated approval to fam-trastuzumab deruxtecan-nxki for HER2-mutant non-small cell lung cancer. FDA. August 16, 2022. Accessed September 5, 2023. https://bit.ly/3Eshzm2
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