%0 Journal Article
%T Meeting with triumph and disaster: Osimertinib in T790M
%A Francesca Bozzetti
%A Francesco Facchinetti
%A Giovanni Ceccon
%A Girolamo Crisi
%A Irene Florindo
%A Marcello Tiseo
%A Roberta Minari
%A Teresa Zielli
%J Tumori Journal
%@ 2038-2529
%D 2018
%R 10.1177/0300891618809826
%X Treatment paradigms for EGFR-mutated non-small cell lung cancer (NSCLC) have successfully evolved since the introduction of osimertinib. The detection of EGFR T790M mutation in plasma or tumor samples obtained at disease progression to first-/second-generation EGFR inhibitors is mandatory for osimertinib prescription. Nevertheless, pharmacokinetics properties of osimertinib guarantee its usefulness in central nervous system (CNS) disease even in the case of T790M-negative or unknown status. In this brief report, we share the clinical histories of two patients with CNS-preeminent progression under first-/second-generation EGFR inhibitors in which it was not possible to document the presence of T790M resistance mutation. Patient outcomes diverged dramatically due to the differential availability of off-label osimertinib. Waiting for the novel molecule to be approved and licensed in first-line treatment, our report of hope and frustration is intended to stress the opportunity of its administration in the case of CNS failure of first-line EGFR inhibition, even in the absence of T790M proof
%K Central nervous system disease
%K EGFR mutation
%K Non-small cell lung cancer (NSCLC)
%K Osimertinib
%K T790M mutation
%U https://journals.sagepub.com/doi/full/10.1177/0300891618809826