Germ-line exon 21 EGFR V831H mutation in advanced NSCLC resistance to almonertinib: a case report

This case highlights primary resistance to the third-generation EGFR-TKI almonertinib in a patient with NSCLC harboring a germ-line EGFR V831H mutation. The rapid progression suggests that this specific germ-line variant may confer inherent TKI resistance, potentially exacerbated by the presence of a concurrent KRAS G12V mutation and drug-drug interactions between almonertinib and antituberculosis medications. It underscores the clinical challenge of germ-line EGFR mutations and emphasizes the need for further research to establish effective therapeutic strategies for such rare genotypes.