Case Report: Aumolertinib as Neoadjuvant Therapy for Patients With Unresectable Stage III Non-Small Cell Lung Cancer With Activated EGFR Mutation: Case Series

Abstract

BackgroundThere is no standard treatment for stage III lung cancer due to its low surgical resection rate, and improving PFS and survival of patients with III NSCLC has become an urgent challenge in clinical treatment. For EGFR mutation-positive patients, targeted therapy has the remarkable feature of high efficiency and low toxicity compared with first-line standard chemotherapy, and targeted neoadjuvant therapy needs to be further explored.MethodWe report 3 diagnosed cases of locally advanced unresectable NSCLC with EGFR-sensitive mutations who first received 1–2 cycles of preoperative chemotherapy neoadjuvant therapy and were treated with 110 mg daily of 3rd-generation EGFR-TKI aumolertinib instead because of poor efficacy or safety intolerance.ResultAfter 2 cycles of aumolertinib treatment, all 3 patients achieved symptomatic remission and significant tumor size reduction and achieved downstaging to allow surgical treatment. No additional operative difficulties were added during the surgery. They continued to receive adjuvant therapy with the original dose of aumolertinib after surgical treatment, and no evidence of tumor recurrence was found until the most recent imaging examination. In addition, the course of neoadjuvant and adjuvant therapy was free of serious adverse effects.ConclusionPerioperative treatment of these three cases of locally advanced unresectable NSCLC with EGFR-sensitive mutations with the third-generation EGFR-TKI aumolertinib showed significant efficacy and excellent safety and may be a new option for targeted therapy in the perioperative period.

Almonertinib as a neoadjuvant therapy for patients with a superior pulmonary sulcus tumor with activated EGFR mutation: A case report

“…Likewise, the EMERGING-CTONG 1103 study (25) revealed that there is a tendency toward an improved overall response rate, lymph node step-down, major pathological response and R0 resection rate with the neoadjuvant erlotinib, in comparison with a neoadjuvant chemotherapy for patients who suffered from EGFRm NSCLC and chronic progression-free survival to a great extent. According to the indications from case reports and other reported clinical tests, EGFR-tyrosine kinase inhibitor (EGFR-TKI) therapy before surgery can achieve a certain effect for patients with resectable NSCLC (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), which indicates that neoadjuvant targeted therapy can also become a clinical option. Based on superior sulcus tumors exhibiting the same biological behavior as other lung cancers (37), we consider that neoadjuvant targeted therapy may be a consideration for superior sulcus tumors.…”

A graphSAGE discovers synergistic combinations of Gefitinib, paclitaxel, and Icotinib for Lung adenocarcinoma management by targeting human genes and proteins: the RAIN protocol

“…Aumolertinib operates by inhibiting the activity of EGFR whose aberration causes cancers. [195][196][197][198][199][200][201] Savolitinib, designed as a small molecule inhibitor targeting the tyrosine kinase of the mesenchymal epithelial transition factor (MET), is mainly intended for treating non-small cell lung cancer (NSCLC) associated with MET mutations. Functioning as a MET tyrosine kinase inhibitor with high specificity, it exhibits promise in treating various cancers, such as NSCLC, breast, head and neck, colorectal, gastric, pancreatic, and other gastrointestinal cancers.…”

Neoadjuvant targeted therapy for resectable EGFR-mutant non-small cell lung cancer: Current status and future considerations

“…This result may be highly related to the inhibitory nature of EGFR-TKIs’ anti-tumor mechanism and spatial heterogeneity within the tumor. Feng et al (2022) recently reported 3 cases of EGFR-mutant stage III unresectable NSCLC who initially received 1-2 cycles of neoadjuvant chemotherapy but were replaced with 2 cycles of neoadjuvant aumolertinib therapy due to poor therapeutic efficacy or intolerance of chemotherapy. Interestingly, two of these patients obtained MPR and another one obtained pCR.…”