Xiang Han,1 Yunhong You,1 Xiuhui Guo,2 Youxin Ji,1 Keke Nie1 

1Department of Oncology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao, 266042, People’s Republic of China; 2Department of Oncology, Pingdu People’s Hospital, Qingdao, 266077, People’s Republic of China

Correspondence: Youxin Ji; Keke Nie, Department of Oncology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, 127 Si Liu South Road, Qingdao, People’s Republic of China, Tel +86532-6866-5078, Fax +86532-8486-3506, Email jiyouxin@uor.edu.cn; niekeke@uor.edu.cn

Purpose: To investigate the efficiency and safety of afatinib in combination with bevacizumab in patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) G719X, S768I, and L861Q mutations.
Patients and Methods: We retrospective studied treatment naïve patients with local advanced or metastatic non-small cell lung cancer harboring EGFR G719X, S768I, and L861Q mutations from January 2017 to August 2021. EGFR tyrosine kinase inhibitors (TKIs) were the first-line treatment in all patients. The demographic, clinical data and treatment results were collected and analyzed.
Results: A total of 12 Chinese patients were studied. There were seven EGFR G719X mutations, three of the seven patients with single mutation and the others with compound mutations. Four patients had EGFR S768I mutations and one of them with single mutation. Four patients had EGFR L861Q/P mutations and one of them with compound mutations. The overall response rate of the EGFR TKIs treatment was 58.33% (7/12). The median progression-free survival (PFS) was 11.0 months, and median overall survival (OS) was 35.40 months. Two of five (40%) patients had required EGFR T790M mutations after TKIs were resistant. The side effects were mild to moderate hand-foot-syndrome, hypertension, and proteinuria.
Conclusion: Afatinib in combination with bevacizumab are effective and safe in the management of patients with NSCLC harboring EGFR G719X, S768I, L861Q/P single or compound mutations.

Keywords: epidermal growth factor receptor tyrosine kinase inhibitor, uncommon EGFR mutations, non-small-cell lung cancer, afatinib, bevacizumab