Real-World NSCLC Case Study | Concurrent Uncommon EGFR Mutations & ALK Rearrangement Treated with Brigatinib

Contributed By :  Dr. Suresh Babu
Published On 2026-07-30 07:03 GMT   |   Update On 2026-07-30 07:07 GMT
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In this expert case presentation, Dr. Suresh Babu discusses the management of a rare case of Stage IV non-small cell lung cancer (NSCLC) in a young postpartum patient harboring concurrent uncommon EGFR mutations (G719X and S768I), an EML4-ALK rearrangement, and a TP53 mutation. Comprehensive molecular profiling using PCR, FISH, next-generation sequencing (NGS), and liquid biopsy enabled accurate characterisation of this complex dual-driver tumour and informed treatment selection.

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Given the absence of established treatment sequencing strategies for concurrent EGFR- and ALK-positive NSCLC, first-line brigatinib was selected. The patient achieved a complete metabolic response within three months, with good tolerability and sustained clinical stability.

This case underscores the importance of comprehensive molecular testing in advanced NSCLC with rare coexisting driver alterations and highlights the value of an individualized precision oncology approach when evidence-based treatment guidance is limited.

Key takeaway: Comprehensive molecular profiling is essential in rare dual-driver NSCLC, and individualized treatment decisions can help optimize outcomes in complex molecular scenarios.


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