Treatment History

• 11/20/07 – 1/30/08: Concurrent chemoradiation with four cycles of cisplatin-navelbine
• 3/11/08: PET/CT with good response, no new disease
• 9/15/09: Surveillance CT imaging suggested recurrence and PET/CT indicated new right posterior medial lower lobe lung nodule (0.9 x 1.0 cm; not metabolically active), right diaphragmatic lesion (1.3 x 1.5 cm; mSUV 2.8), and bone metastases
• 10/1/09: New biopsy was pathologically consistent with adenocarcinoma of the lung and molecular testing was positive for EGFR L858R (sensitizing mutation)
• 11/19/09: Erlotinib 150mg/day
• 11/2/11: Disease progression in lung, stable bone metastases, no metastases below the diaphragm
• 2/1/12: New biopsy was pathologically consistent with adenocarcinoma of the lung and molecular testing was positive for EGFR L858R (sensitizing) and EGFR T790M (resistant)
• 3/1/12: Enrolled and treated on clinical trial (THO-09103) with single agent afatinib 40mg/day
• 9/13/12: Disease progression in the lung, so was crossed over to afatinib 40mg/day plus cetuximab 500 mg/m2 IV Q2W
• 10/12/15: Disease progression in lung, stable bone metastases, no metastases below the diaphragm
• 11/11/15 and 11/19/15: Cetuximab and afatinib were discontinued, respectively
• 11/2/2015: Cell-free DNA from the blood had been evaluated for genomic alterations; EGFR L858R and T790M mutations were both identified
• 11/20/15: Osimertinib 80 mg/day
• 6/13/16: Disease progression in lung, stable bone metastases, no metastases below the diaphragm
• 6/20/16: New biopsy was pathologically consistent with adenocarcinoma of the lung and molecular testing was positive for EGFR L858R (sensitizing) and negative for EGFR T790M and was without small cell transformation
• 7/14/16: Erlotinib 100 mg/day
• 8/6/16: Disease progression in lung, stable bone metastases, no metastases below the diaphragm