Neoadjuvant Targeted Therapy with Dacomitinib in a Stage IIIA Non-Small-Cell Lung Cancer Patient Harboring EGFR G719X: A Case Report

Dan Li,* Xin Liu,* Yang Liu, Yue Zhu, Dafu Yang, Jincheng Song, Zhaoxia Dai Department of Medical Oncology, The Second Hospital of Dalian Medical University, Dalian, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jincheng Song, Department of Medical Oncology, The Second Hospital of Dalian Medical University, No. 467, Zhongshan Road, Shahekou District, Dalian, People’s Republic of China, Email [email protected] Zhaoxia Dai, Department of Medical Oncology, The Second Hospital of Dalian Medical University, No. 467, Zhongshan Road, Shahekou District, Dalian, People’s Republic of China, Email [email protected]: The effectiveness of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) has been established, leading the NCCN Guidelines to recommend it as a first-line treatment for patients with advanced EGFR mutation-positive non-small cell lung cancer (NSCLC). However, there is still controversy about the use of neoadjuvant TKI treatment for patients with stage III EGFR mutation-positive NSCLC. Here, we firstly report that a stage IIIA lung adenocarcinoma patient benefited from chemotherapy and dacomitinib as neoadjuvant targeted therapy based on EGFR G719X mutation, achieving a pathological downstaging and the chance of radical surgical resection. Our case describes dacomitinib use as neoadjuvant targeted therapy for EGFR positive advanced NSCLC and highlights the application of molecular testing for the better treatment decision making.Keywords: uncommon EGFR mutations, EGFR G719X, neoadjuvant targeted therapy, dacomitinib, NSCLC