• Dapeng Li, Qi Gui, Caihua Xu, Meng Shen, and Kai Chen.
• Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
• Medicine (Baltimore). 2021 Jul 30; 100 (30): e26375e26375.

RationaleBesides the T790 M mutation, it may coexist with bypass pathway activation in real clinical cases for patients with EGFR mutations who resisted to the first- and second-generation tyrosine kinase inhibitors (TKIs) in non-small cell lung cancer (NSCLC). There are limited clinical trial data describing the efficacy of osimertinib combined with MET inhibition in EGFR T790M-mutant NSCLC patients with Met amplification.Patient ConcernsA non-smoking 53-year-old male patient with lung adenocarcinoma underwent gefitinib, afatinib, and osimertinib combined with crizotinib treatment and developed different EGFR resistance mutations.DiagnosesThe patient was diagnosed with lung adenocarcinoma (stage cT4N2M0, IIIB). After resistance to the therapy targeting EGFR exon 21 L858R point mutation, T790 M mutation was detected in liquid biopsy and Met amplification was detected via tissue biopsy by next-generation sequencing (NGS).InterventionsThe patient received systemic treatments, including chemotherapy, gefitinib, afatinib, and osimertinib combined with crizotinib.OutcomesThe patient died of multisystem organ failure and had an overall survival of 24 months.LessonsAlthough osimertinib combined with crizotinib therapy showed dramatic tumor shrinkage in both the primary tumor and bone metastasis to an EGFR T790M-mutant NSCLC patient with MET amplification, the progression-free survival (PFS) was only two months.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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