Intrahepatic cholangiocarcinoma patient with epidermal growth factor receptor exon 19 deletion unresponsive to Afatinib monotherapy: a case report

表皮生长因子受体19号外显子缺失的肝内胆管癌患者对阿法替尼单药治疗无反应:病例报告

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Abstract

BACKGROUND: The efficacy of epidermal growth factor receptor EGFR tyrosine kinase inhibitors in cholangiocarcinoma (CCA) patients is still unknown. Here, we report a 67-year-old CCA patient with EGFR exon 19 deletion receiving afatinib treatment. CASE DESCRIPTION: A 67-year-old male was referred to our hospital due to persistent abdominal pain for 3 months. Abdominal computed tomography showed a tumor with a diameter of 92 mm in the left liver with multiple intrahepatic metastases. Immunohistochemistry revealed that tumor cells were positive for CK7 and CK19, and negative for hepatocyte and CDX- 2. A pathological diagnosis of intrahepatic CCA was made. Since the patient declined standard chemotherapy, afatinib was administered as the first-line treatment. Upon disease progression, apatinib was introduced. Unfortunately, the patient ultimately succumbed to hepatic failure, with a total survival of 1.8 months. CONCLUSION: In this report, the CCA patient with EGFR exon 19 deletion was unresponsive to afatinib treatment. However, genetic testing may be still worthwhile for CCA to increase the possible treatment options.

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