case_images: PMC10546178_01
case_images: Timeline of the clinical therapy with Icotinib. (A) HRCT image of the patient at baseline. (B) HRCT image of the patient after taking Icotinib for 1.5 months, 12 months (C), and 19 months (D). the level of CEA was shown in the black box. The position of the tumor was denoted by red arrows.
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case_images: PMC10546178_01_fonc-13-1129629-g001.jpg
case_images: f1
case_images: Hospital due to paroxysmal chest pain, left pleural effusion, and bilateral pulmonary nodules on December 21, 2020. The tissue sample was acquired from a "CT-guided core biopsy of inferior lobe of left lung occupying lesion" and was sequentially sent to the Department of Pathology for a pathologic exam. High-resolution computed tomography (HRCT) scanning showed multiple nodules (1.0 cm in diameter) throughout the lung and a space-occupying lesion (1.8 cm x 2.2 cm) on the lower lobe of the left lung (Figure 1A). The CT images showed a partiale response to treatment, in particular, the size of most nodules around the lung reduced (1.0cm to 0.7cm in diameter), the nodules on the lower lobe of the left lung rapidly shrank down from 1.8 cm x 2.2 cm to 1.3 cmx1.1 cm, and many nodules in the lung even disappeared (Figures 1A, B). The total follow-up time was 19 months. Up to the last follow-up, the level of CEA decreased significantly from 138.6 ng/ml to 13.82 ng/ml (Figures 1C, D).
case_images: E746_S752delinsI mutation in EGFR Exon 19 identified by NGS. Red boxes: missing bases of EGFR.
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case_images: PMC10546178_01_fonc-13-1129629-g002.jpg
case_images: f2
case_images: A NGS panel (Dian diagnostics, Hangzhou, China), targeting ten driver mutational genes (EGFR, KRAS, BRAF, ERBB2, NRAS, ALK, MET, RET, ROS1, PIK3CA), highlighted an EGFR p.E746_S752delinsI mutation with 29.62% of Variant Allele Frequency (VAF) of the tissue sample (Figure 2).
case_images: PMC10546178_02
case_images: The results of NGS testing displayed by IGV. (A) T751_I759delinsG mutation in EGFR Exon 19. (B) L747_S752delinsAA mutation in EGFR Exon 19. Red boxes: missing or mutated bases of EGFR Exon19.
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case_images: f3
case_images: The NGS testing highlighted a novel EGFR p.L747_S752delinsAA mutation with 19.6% VAF (Figure 3B).
case_images: PMC10546178_03
case_images: The results of NGS testing displayed by IGV. (A) T751_I759delinsG mutation in EGFR Exon 19. (B) L747_S752delinsAA mutation in EGFR Exon 19. Red boxes: missing or mutated bases of EGFR Exon19.
case_images: fonc-13-1129629-g003.jpg
case_images: PMC10546178_03_fonc-13-1129629-g003.jpg
case_images: f3
case_images: The NGS testing highlighted a novel EGFR p.L747_S752delinsAA mutation with 19.6% VAF (Figure 3B).