A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature Review

Non-small-cell lung cancer (NSCLC) exemplifies how biomarker-driven therapies can alter the natural course of a disease. Clinically significant mutations in the epidermal growth factor receptor (EGFR) in NSCLC include a spectrum of substitutions, deletions, and insertions, mainly affecting exons 18...

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Main Authors: Laura Gutiérrez-Sainz, Rocío Rosas-Alonso, Carlos Rodríguez-Antolín, Carmen Rodríguez-Jiménez, Isabel Esteban Rodríguez, Rafael Peláez, Oliver Higuera Gómez, Julia Villamayor, Patricia Cruz-Castellanos, Alberto Peláez-García, Inmaculada Ibáñez de Cáceres, Javier de Castro Carpeño
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Current Problems in Cancer: Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666621925000262
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author Laura Gutiérrez-Sainz
Rocío Rosas-Alonso
Carlos Rodríguez-Antolín
Carmen Rodríguez-Jiménez
Isabel Esteban Rodríguez
Rafael Peláez
Oliver Higuera Gómez
Julia Villamayor
Patricia Cruz-Castellanos
Alberto Peláez-García
Inmaculada Ibáñez de Cáceres
Javier de Castro Carpeño
author_facet Laura Gutiérrez-Sainz
Rocío Rosas-Alonso
Carlos Rodríguez-Antolín
Carmen Rodríguez-Jiménez
Isabel Esteban Rodríguez
Rafael Peláez
Oliver Higuera Gómez
Julia Villamayor
Patricia Cruz-Castellanos
Alberto Peláez-García
Inmaculada Ibáñez de Cáceres
Javier de Castro Carpeño
author_sort Laura Gutiérrez-Sainz
collection DOAJ
description Non-small-cell lung cancer (NSCLC) exemplifies how biomarker-driven therapies can alter the natural course of a disease. Clinically significant mutations in the epidermal growth factor receptor (EGFR) in NSCLC include a spectrum of substitutions, deletions, and insertions, mainly affecting exons 18 to 21. The most common EGFR mutations involve exon 19 deletions (19del) or the exon 21 L858R substitution, which are typically sensitive to tyrosine kinase inhibitors (TKIs) such as osimertinib. However, 10 % to 20 % of patients harbor uncommon EGFR mutations, which exhibit variable responses to TKIs. Notably, some rare exon 19 mutations are often undetectable by conventional polymerase chain reaction (PCR) assays. In this case report, we describe an NSCLC patient with a novel exon 19 EGFR mutation identified by next-generation sequencing (NGS), which was not detected by commercial PCR assays. The patient experienced a modest response to osimertinib. We also provide a review of the current literature regarding these uncommon EGFR mutations.
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spelling doaj-art-1308f063f9cd4bb9a50da683ccc38a702025-08-20T02:17:09ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192025-06-011810037410.1016/j.cpccr.2025.100374A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature ReviewLaura Gutiérrez-Sainz0Rocío Rosas-Alonso1Carlos Rodríguez-Antolín2Carmen Rodríguez-Jiménez3Isabel Esteban Rodríguez4Rafael Peláez5Oliver Higuera Gómez6Julia Villamayor7Patricia Cruz-Castellanos8Alberto Peláez-García9Inmaculada Ibáñez de Cáceres10Javier de Castro Carpeño11Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Medical Oncology Department, La Paz University Hospital, IdiPAZ, Madrid, Spain; Corresponding author at: La Paz University Hospital, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain.Experimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Cancer Epigenetics Laboratory, INGEMM, La Paz University Hospital, 28046, Madrid, SpainExperimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Cancer Epigenetics Laboratory, INGEMM, La Paz University Hospital, 28046, Madrid, SpainGenetics of Metabolic Diseases, Departments of Genetics, La Paz University Hospital, Madrid, SpainExperimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Pathology Department, La Paz University Hospital, 28046, Madrid, SpainLaboratorio de Química Orgánica y Farmacéutica, Departamento de Ciencias Farmacéuticas, Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, 37007, Salamanca, SpainMedical Oncology Department, La Paz University Hospital, IdiPAZ, Madrid, SpainExperimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Medical Oncology Department, La Paz University Hospital, IdiPAZ, Madrid, SpainExperimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Medical Oncology Department, La Paz University Hospital, IdiPAZ, Madrid, Spain; Medical Oncology Department, Hospital General Universitario de Ciudad Real, Ciudad Real, SpainMolecular Pathology and Therapeutic Targets Group, La Paz University Hospital, IdiPAZ, Madrid, SpainExperimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Cancer Epigenetics Laboratory, INGEMM, La Paz University Hospital, 28046, Madrid, SpainExperimental Therapies and Novel Biomarkers in Cancer, Hospital La Paz Institute for Health Research-IdiPAZ, Madrid, Spain; Medical Oncology Department, La Paz University Hospital, IdiPAZ, Madrid, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, SpainNon-small-cell lung cancer (NSCLC) exemplifies how biomarker-driven therapies can alter the natural course of a disease. Clinically significant mutations in the epidermal growth factor receptor (EGFR) in NSCLC include a spectrum of substitutions, deletions, and insertions, mainly affecting exons 18 to 21. The most common EGFR mutations involve exon 19 deletions (19del) or the exon 21 L858R substitution, which are typically sensitive to tyrosine kinase inhibitors (TKIs) such as osimertinib. However, 10 % to 20 % of patients harbor uncommon EGFR mutations, which exhibit variable responses to TKIs. Notably, some rare exon 19 mutations are often undetectable by conventional polymerase chain reaction (PCR) assays. In this case report, we describe an NSCLC patient with a novel exon 19 EGFR mutation identified by next-generation sequencing (NGS), which was not detected by commercial PCR assays. The patient experienced a modest response to osimertinib. We also provide a review of the current literature regarding these uncommon EGFR mutations.http://www.sciencedirect.com/science/article/pii/S2666621925000262Non-small-cell lung cancer (NSCLC)Epidermal growth factor receptor (EGFR) mutationsnovel exon 19 EGFR mutation
spellingShingle Laura Gutiérrez-Sainz
Rocío Rosas-Alonso
Carlos Rodríguez-Antolín
Carmen Rodríguez-Jiménez
Isabel Esteban Rodríguez
Rafael Peláez
Oliver Higuera Gómez
Julia Villamayor
Patricia Cruz-Castellanos
Alberto Peláez-García
Inmaculada Ibáñez de Cáceres
Javier de Castro Carpeño
A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature Review
Current Problems in Cancer: Case Reports
Non-small-cell lung cancer (NSCLC)
Epidermal growth factor receptor (EGFR) mutations
novel exon 19 EGFR mutation
title A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature Review
title_full A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature Review
title_fullStr A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature Review
title_full_unstemmed A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature Review
title_short A Novel Exon 19 EGFR mutation in a patient with lung adenocarcinoma: A Case Report and Literature Review
title_sort novel exon 19 egfr mutation in a patient with lung adenocarcinoma a case report and literature review
topic Non-small-cell lung cancer (NSCLC)
Epidermal growth factor receptor (EGFR) mutations
novel exon 19 EGFR mutation
url http://www.sciencedirect.com/science/article/pii/S2666621925000262
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