Early disease control with a biochemical response to aumolertinib after postoperative recurrence of EGFR-Mutant stage IIIA lung adenocarcinoma after icotinib, with EGFR T790M detected at recurrence: a Case Report
- 1Huzhou Central Hospital, The Affiliated Central Hospital of Huzhou Normal University , , ,
- 2Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University , , ,
- 3Department of Central Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou Normal University , , ,
Abstract
Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are a standard treatment for EGFR-mutant non-small cell lung cancer (NSCLC). However, acquired resistance commonly develops after treatment with first- or second-generation EGFR-TKIs. Aumolertinib, a third-generation EGFR-TKI, has demonstrated efficacy in tumors harboring the EGFR exon 20 T790M resistance mutation.
Case Presentation: A 57-year-old man with stage IIIA lung adenocarcinoma and a history of hypertension and long-term smoking underwent thoracoscopic lobectomy with intrapulmonary lymph node dissection. Postoperative molecular testing identified an EGFR exon 19 deletion, and adjuvant oral icotinib (375 mg/d) was initiated. After treatment discontinuation, disease recurrence was detected on PET-CT involving the right hilar lymph nodes and a right pleural/subpleural lesion, which was confirmed by biopsy. Repeat molecular testing revealed concurrent EGFR exon 19 deletion and EGFR exon 20 T790M mutation. After 1 month of aumolertinib treatment, the target lesion decreased in size from 24 to 23 mm and was assessed as stable disease according to RECIST version 1.1, whereas the serum CEA level decreased from 24.19 to 4.35 ng/mL, indicating early disease control with a biochemical response.
Conclusion: This case demonstrates early disease control and a biochemical response to aumolertinib treatment in recurrent NSCLC with an EGFR exon 20 T790M mutation detected at recurrence. It also highlights the importance of repeat molecular testing to guide therapeutic decisions.
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BibTeX
@article{niu2026early,
title = {{Early disease control with a biochemical response to aumolertinib after postoperative recurrence of EGFR-Mutant stage IIIA lung adenocarcinoma after icotinib, with EGFR T790M detected at recurrence: a Case Report}},
author = {Zhenyu Niu and Yin Zhu and Yu Zhou and Yunhong Xu and Lili Jin and Qibin Shen},
journal = {Frontiers in pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1878253},
url = {https://europepmc.org/article/PMC/PMC13668514},
note = {CC BY},
}
RIS
TY - JOUR
TI - Early disease control with a biochemical response to aumolertinib after postoperative recurrence of EGFR-Mutant stage IIIA lung adenocarcinoma after icotinib, with EGFR T790M detected at recurrence: a Case Report
AU - Zhenyu Niu
AU - Yin Zhu
AU - Yu Zhou
AU - Yunhong Xu
AU - Lili Jin
AU - Qibin Shen
PY - 2026
DA - 2026/10/01
JO - Frontiers in pharmacology
DO - 10.3389/fphar.2026.1878253
UR - https://europepmc.org/article/PMC/PMC13668514
AB - Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are a standard treatment for EGFR-mutant non-small cell lung cancer (NSCLC). However, acquired resistance commonly develops after treatment with first- or second-generation EGFR-TKIs. Aumolertinib, a third-generation EGFR-TKI, has demonstrated efficacy in tumors harboring the EGFR exon 20 T790M resistance mutation. Case Presentation: A 57-year-old man with stage IIIA lung adenocarcinoma and a history of hypertension and long-term smoking underwent thoracoscopic lobectomy with intrapulmonary lymph node dissection. Postoperative molecular testing identified an EGFR exon 19 deletion, and adjuvant oral icotinib (375 mg/d) was initiated. After treatment discontinuation, disease recurrence was detected on PET-CT involving the right hilar lymph nodes and a right pleural/subpleural lesion, which was confirmed by biopsy. Repeat molecular testing revealed concurrent EGFR exon 19 deletion and EGFR exon 20 T790M mutation. After 1 month of aumolertinib treatment, the target lesion decreased in size from 24 to 23 mm and was assessed as stable disease according to RECIST version 1.1, whereas the serum CEA level decreased from 24.19 to 4.35 ng/mL, indicating early disease control with a biochemical response. Conclusion: This case demonstrates early disease control and a biochemical response to aumolertinib treatment in recurrent NSCLC with an EGFR exon 20 T790M mutation detected at recurrence. It also highlights the importance of repeat molecular testing to guide therapeutic decisions.
SN - 1663-9812
ER -