Successful treatment with erlotinib plus ramucirumab in a patient with non-small-cell lung cancer harboring EGFR exon 20 insertion mutation.

As epidermal growth factor receptor ( EGFR ) exon 20 insertion mutations generally result in poor sensitivity to EGFR -tyrosine kinase inhibitors (TKIs), the administration of EGFR -TKIs is not recommended in non-small-cell lung cancer (NSCLC). Nonetheless, EGFR exon 20 A763_Y763insFQEA, a genotype of EGFR exon 20 insertion mutations, has some sensitivity to EGFR -TKIs. However, the therapeutic effects of EGFR -TKIs alone for EGFR exon 20 A763_Y763insFQEA are insufficient compared to those for common EGFR mutations. Therefore, more effective treatment options are required for this mutation. Herein, we present a case in which treatment with erlotinib plus ramucirumab led to a complete response and progression-free survival of 13 months in a 79-year-old man with advanced NSCLC harboring EGFR exon 20 A763_Y763insFQEA. This case suggests that this regimen should be considered as an effective treatment option for such patients.