Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature review

Pancreatic cancer is a rising cause of cancer death. Therapeutic options are scarce and of limited efficacy. Up to 26% of patients with metastatic pancreatic cancer could benefit from targeted therapies. We report here for the first time the case of three patients with metastatic pancreatic ductal a...

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Main Authors: Timothée Vigié, Alexandre Perrier, Brice Chanez, Julien De Martino, Loëtitia Favre, Florence Coulet, Jean-Baptiste Bachet, Erell Guillerm, Léo Mas
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Therapeutic Advances in Medical Oncology
Online Access:https://doi.org/10.1177/17588359241312078
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author Timothée Vigié
Alexandre Perrier
Brice Chanez
Julien De Martino
Loëtitia Favre
Florence Coulet
Jean-Baptiste Bachet
Erell Guillerm
Léo Mas
author_facet Timothée Vigié
Alexandre Perrier
Brice Chanez
Julien De Martino
Loëtitia Favre
Florence Coulet
Jean-Baptiste Bachet
Erell Guillerm
Léo Mas
author_sort Timothée Vigié
collection DOAJ
description Pancreatic cancer is a rising cause of cancer death. Therapeutic options are scarce and of limited efficacy. Up to 26% of patients with metastatic pancreatic cancer could benefit from targeted therapies. We report here for the first time the case of three patients with metastatic pancreatic ductal adenocarcinoma (PDAC) without KRAS alteration for whom an activating mutation in exon 19 of the epidermal growth factor receptor ( EGFR ) gene was found through mainstreaming NGS. The EGFR variant was confirmed on multiple tumor samples and by circulating tumor DNA (ctDNA) analysis in two patients. The three patients were treated with osimertinib with early molecular, biologic, and morpho-metabolic responses. At the last follow-up, one patient had an ongoing response after 17 months, and disease control had been maintained for 8 and 6 months in the other two. Known resistance mechanisms were observed on ctDNA analysis at progression. These observations demonstrate the benefit of osimertinib for treating EGFR -mutated PDAC and highlight the interest in investigating rare molecular alterations, especially in patients without KRAS alterations.
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publishDate 2025-03-01
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series Therapeutic Advances in Medical Oncology
spelling doaj-art-5c3423ccf27a4ac4a9242f0c7fa4e5f82025-08-20T03:42:19ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592025-03-011710.1177/17588359241312078Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature reviewTimothée VigiéAlexandre PerrierBrice ChanezJulien De MartinoLoëtitia FavreFlorence CouletJean-Baptiste BachetErell GuillermLéo MasPancreatic cancer is a rising cause of cancer death. Therapeutic options are scarce and of limited efficacy. Up to 26% of patients with metastatic pancreatic cancer could benefit from targeted therapies. We report here for the first time the case of three patients with metastatic pancreatic ductal adenocarcinoma (PDAC) without KRAS alteration for whom an activating mutation in exon 19 of the epidermal growth factor receptor ( EGFR ) gene was found through mainstreaming NGS. The EGFR variant was confirmed on multiple tumor samples and by circulating tumor DNA (ctDNA) analysis in two patients. The three patients were treated with osimertinib with early molecular, biologic, and morpho-metabolic responses. At the last follow-up, one patient had an ongoing response after 17 months, and disease control had been maintained for 8 and 6 months in the other two. Known resistance mechanisms were observed on ctDNA analysis at progression. These observations demonstrate the benefit of osimertinib for treating EGFR -mutated PDAC and highlight the interest in investigating rare molecular alterations, especially in patients without KRAS alterations.https://doi.org/10.1177/17588359241312078
spellingShingle Timothée Vigié
Alexandre Perrier
Brice Chanez
Julien De Martino
Loëtitia Favre
Florence Coulet
Jean-Baptiste Bachet
Erell Guillerm
Léo Mas
Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature review
Therapeutic Advances in Medical Oncology
title Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature review
title_full Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature review
title_fullStr Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature review
title_full_unstemmed Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature review
title_short Prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion: a case report and literature review
title_sort prolonged response to osimertinib in three patients with refractory metastatic pancreatic adenocarcinomas with exon 19 deletion a case report and literature review
url https://doi.org/10.1177/17588359241312078
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