EGFR-RAD51 fusion

We report a widely metastatic non-small cell lung cancer in a never-smoker young male patient with sustained near-complete systemic and intracranial response to osimertinib, a third-generation EGFR tyrosine-kinase inhibitor (TKI). We also review the available data of other TKIs in this scenario and underscore the role of comprehensive molecular testing for NSCLC.

In this study, we report a case of EGFR-RAD51 fusion in lung adenocarcinoma that showed a response to icotinib; these findings provide additional support for the use of EGFR-TKIs for patients with these atypical variants. KEY POINTS: A young patient with lung adenocarcinoma harboring a rare EGFR-RAD51 fusion who responded to icotinib with a PFS of longer than 15 months.All reported EGFR-RAD51 fusions have the same breakpoints and show responses to EGFR-TKIs including icotinib, except for one patient who responded to chemotherapy.Although EGFR fusion is a rare EGFR variant type, the efficacy of EGFR-TKIs suggests the necessity for new detection technology, such as NGS, for patients with lung adenocarcinoma.The clinical usage of NGS could maximize the benefits of precision medicine in patients with cancer.The current case provides new evidence for the efficacy of icotinib in patients with the rare EGFR-RAD51 fusion and EGFR-activating mutations.