Durable response to afatinib rechallenge in a long‐term survivor of non‐small cell lung cancer harboring <scp><i>EGFR</i> L858R</scp> and <scp>L747V</scp> mutations

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<jats:title>Abstract</jats:title><jats:p>Epidermal growth factor receptor (EGFR)‐tyrosine kinase inhibitors are standard therapeutic agents for non‐small cell lung cancer (NSCLC) patients with major <jats:italic>EGFR</jats:italic> mutations such as exon 19 deletions and a L858R mutation, whereas treatment strategies for cases with uncommon <jats:italic>EGFR</jats:italic> mutations remain to be fully established. Here, we report a long‐term (≥20 years from initial diagnosis) NSCLC survivor carrying <jats:italic>EGFR</jats:italic> L858R and L747V mutations. The patient received gefitinib monotherapy, systemic chemotherapy/chemoimmunotherapy, and local consolidative therapies for oligometastatic lesions, and responded to afatinib rechallenge with a progression‐free survival of 12 months. The current case suggests that afatinib is effective in NSCLC patients with <jats:italic>EGFR</jats:italic> L858R and L747V mutations and that a therapeutic approach combining appropriately timed systemic therapies with local consolidative therapies for oligometastatic lesions improves long‐term survival.</jats:p>

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