case_images: PMC9868826_01
case_images: Biopsy pathology of a tumor of the lung lesion. (A) HE staining of the patient's lung lesion, (B) IHC staining of the patient's lung lesion.
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case_images: NapsinA(-), P63(-), GATA3(-), CK20(-) ( Figures 1A, B ). NSG sequencing suggests EGFR mutations (p.GLY719Cys (22.34%) and EGFR-p.Glu709Val (23.24%) in lung adenocarcinoma.
case_images: The cranial MR and CT of the chest before and after lazertinib and amivantamab treatment. (A) In May 2021, cranial MR showed multiple abnormal signals in the left frontoparietal-occipital lobe, basal ganglia region, thalamus, and right cerebellar hemisphere; (B) In July 2021, CT of the chest showed pulmonary atelectasis and pleural effusion.
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case_images: Cranial MR showed multiple abnormal signals in the left frontoparietal-occipital lobe, basal ganglia region, thalamus, and right cerebellar hemisphere ( Figure 2A ). On June 19, CT of the chest showed pulmonary atelectasis and pleural effusion ( Figure 2B ).
case_images: The CT of the chest after lazertinib and amivantamab treatment. (A) Increased size and number of diffuse nodules in both lungs on chest CT after amivantamab alone on October 9, 2021; (B) Decreased size and number of diffuse nodules in both lungs on chest CT after lazertinib in combination with amivantamab on December 30, 2021.
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case_images: October 9, CT of the chest showed an increase in the size and number of diffuse nodules in both lungs, suggesting progression of the disease ( Figure 3A ). On October 19, treatment with lazertinib in combination with amivantamab (240mg QD + 700mg d1) was started. The condition was disease-stable ( Figure 3B ).
case_images: Timeline of treatment.
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case_images: Statistically, the patient had an OS of 54 months  Figure 4 .