2023-06-29 06:03:00
On June 29, Dr. Manoon Leechawengwong, a specialist in respiratory diseases, critically ill patients, and elderly diseases Vichaiyut Hospital Post a message via the Facebook fan page “Mr. Manoon Lee Chawengwong FC”, stating that “The patient is a 69-year-old Thai woman, healthy, without any abnormal symptoms, non-smoker, no underlying disease. Annual chest x-ray revealed nodules in the upper right lung measuring 2.2 × 2.7 × 2.5 cm (see picture). Lung computation showed enlarged medial thoracic lymph nodes. PET scan confirmed nodules in the lungs and medial ventral lymph nodes. in the chest a puncture in the right lung type of lung cancer found adenocarcinoma Gene mutation test revealed EGFR exon 20 insertion mutation
Conclusion: This is metastatic lung cancer, it cannot be operated because at that time there was no targeted drug for this type of mutated gene. Therefore, chemotherapy was started in early August 2022 by administering ALIMTA and Carboplatin chemotherapy for a total of 8 times. The nodules in the lungs in October 2022 were smaller (see photo). Chemotherapy is no longer effective. Encourage patients to join the program to help them access a new cancer drug Mobocertinib (Exkivity) at Ramathibodi Hospital, giving a dose of 40 mg, taken 4 tablets once a day, every day. Starting in April 2023, the first phase has few side effects. Have a rash and sores in the mouth After adjusting the dosage to 3 tablets once a day decreased side effects In June 2023, after 2 months of taking the drug, the patient responded very well to this new drug. The x-ray showed a much smaller lump in the lungs (see picture). How long will this new drug be effective?
Mobocertinib is the world’s first oral medication. An exon 20 insertion mutation targeting the EGFR gene has been approved for use in the United States. United Kingdom Switzerland, Australia, South Korea and China for the treatment of non-small cell lung cancer with EGFR exon 20 insertion mutation where the disease is locally or metastatic. After ineffective treatment with platinum-based chemotherapy This drug is waiting to be registered in Thailand”..
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