Serial chest CT scans of 33-year-old male with lung adenocarcinoma harboring EGFR-KDD documenting response to afatinib and subsequent acquired resistance.

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Presentation transcript:

Serial chest CT scans of 33-year-old male with lung adenocarcinoma harboring EGFR-KDD documenting response to afatinib and subsequent acquired resistance. Serial chest CT scans of 33-year-old male with lung adenocarcinoma harboring EGFR-KDD documenting response to afatinib and subsequent acquired resistance. A, left image, patient images after six cycles of cisplatin/pemetrexed/bevacizumab (largest mass diameter = 6.62 cm). Middle image, patient images after two cycles of afatinib (largest mass diameter = 2.72 cm). Right image, patient images after seven cycles of afatinib (largest mass diameter = 6.20 cm). The red arrowheads are pointing to the largest mass used for RECIST evaluation. B, copy-number data from FoundationOne NGS targets along chromosome 7 demonstrating amplification of the EGFR-KDD allele at the time of acquired resistance to afatinib (maroon squares) compared with the pre-afatinib tumor biopsy sample (blue squares). The x-axis represents chromosome 7. C, EGFR FISH of pre-afatinib (left image) and post-afatinib (right image) tumor biopsy samples used for the NGS analysis shown in B. Pre-afatinib, 1.6 copies of EGFR per chromosome 7 centromere (1.6 EGFR/CEP7); post-afatinib, 4.2 EGFR/CEP7. Green puncta, CEP7; red puncta, EGFR. Jean-Nicolas Gallant et al. Cancer Discov 2015;5:1155-1163 ©2015 by American Association for Cancer Research