Figure 1 from Clinical and Molecular Characterization of a Rare EGFR cis Compound L833V/H835L Mutation in Non–Small Cell Lung Cancer

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Detection of EGFR L833V/H835L in cis mutations and its histopathologic characteristics in the surgically resected NSCLC. A and B,EGFR c.2497T>G (p.Leu833Val) mutation and EGFR c.2504A>T (p.His835Leu) mutations presenting in cis were detected by NGS analysis (A) of the surgical specimen from patient 8 and Sanger sequencing (B) of the lung biopsy specimen from patient 2. C, Patient 4, a 69-year-old, never-smoker female, was preoperatively evaluated as cN0. Note the gross and microscopic findings of metastatic tumors in a peribronchial lymph node. D, Patient 5, a 62-year-old, never-smoker female, was also preoperatively evaluated as cN0. Pathologic examination of her lobectomy specimen revealed poorly differentiated adenocarcinoma with solid pattern (50%) with PL2 pleural invasion (pT2aN0M0). E, Patient 6, a 74-year-old, never-smoker female. Pathologic examination showed poorly differentiated adenocarcinoma with micropapillary pattern (20%) and both N1 and N2 metastases (pT2N2M0). F, Patient 8, a 79-year-old, never-smoker female, received pneumonectomy of the left lung. Poorly differentiated adenocarcinoma with micropapillary pattern (30%) was identified in the histopathologic examination (pT3N2M0). G, Patient 1, a 53-year-old, ex-smoker male (initial stage: cT1aN2M0). Palliative 1 L gemcitabine/cisplatin obtained PFS of 3 months, whereas the 2 L gefitinib regimen obtained PFS of 17 months. H, Patient 2, a 51-year-old, never-smoker female, (initial stage: cT2aN0M1b, rib metastasis) received 1 L palliative pemetrexed and cisplatin for 1 month, but disease progressed with lung-to-lung metastasis. Four months after the administration of 2 L gefitinib, the extent of innumerable metastatic lung nodules decreased, and the PFS was 9 months. PCR sequencing after the disease progression revealed EGFR T790M mutation. The patient refused to participate in the clinical study and expired after 1 month.

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