An epidermal growth factor receptor compound mutation of L858R with S768I in advanced non-small-cell lung cancer: a case report

Sep 21, 2026

Background: Treatment for advanced or metastatic non-small-cell lung cancer increasingly relies on epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, especially for common EGFR mutations. However, the therapeutic efficacy for rare, highly complex EGFR mutations, particularly double mutations, remains clinically uncertain. Case presentation: A 64-year-old Moroccan man, a lifelong nonsmoker, developed metastatic NSCLC with a complex EGFR mutation combining L858R and S768I. He received afatinib-based therapy with notable outcomes including overall survival of 51 months and progression-free survival exceeding 39 months. Conclusions: This case highlights potential benefit of EGFR-TKIs in rare, complex EGFR mutation settings.

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CategoryHealthcare

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Abstract

Background

Case presentation

Conclusions

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Case report

Boukansa etal. Journal of Medical Case Reports (2024) 18:118 [https://doi.org/10.1186/s13256-024-04422-5](https://doi.org/10.1186/s13256-024-04422-5) Journal of Medical Case Reports CASE REPORT Open Access An epidermal growth factor receptor compound mutation of L858R with S768I in advanced non-small-cell lung cancer: a case report Sara Boukansa 1,2*, Ismail Mouhrach3, Fatima El Agy1,2, Laila Bouguenouch3, Mounia Serraj4, Bouchra Amara4, Yassine Ouadnouni5, Mohamed Smahi5, Badreeddine Alami6, Nawfel Mellas7, Zineb Benbrahim7 and Hinde El Fatemi 1,2 Abstract Background In the current treatment landscape for non-small cell lung cancers, epidermal growth factor receptortyrosine kinase inhibitors have emerged as a well-established treatment option for patients with advanced or metastatic disease. This is particularly true for those with commonly occurring epidermal growth factor receptor mutations. However, the therapeutic efficacy of these agents for so-called rare epidermal growth factor receptor mutations, and in particular those characterized by a high degree of complexity, such as double mutations, remains a subject of clinical uncertainty. Case presentation In this context, we present the case of a 64-year-old man of Moroccan descent, a lifelong nonsmoker, diagnosed with metastatic non-small cell lung cancer characterized by a complex epidermal growth factor receptor mutation encompassing L858R and S768I. The patient subsequently underwent afatinib-based treatment, showing notable clinical results. These included a remarkable overall survival of 51 months, with a median progression-free survival of more than 39 months. Conclusions This case report is a compelling testimony to the evolving therapeutic landscape of non-small cell lung cancers, providing valuable insight into the potential therapeutic efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors in the realm of rare and complex epidermal growth factor receptor mutations. Keywords EGFR mutation, L858R, S768I, Afatinib, Case report *Correspondence: Sara Boukansa [sara.boukansa@usmba.ac. ma](sara.boukansa@usmba.ac. ma); [boukansasara@gmail.com](boukansasara@gmail.com) Full list of author information is available at the end of the article © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[. The Creative Commons Public Domain Dedication waiver (](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[http://creativecom](http://creativecom)[mons.org/publicdomain/zero/1.0/](mons.org/publicdomain/zero/1.0/)) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Boukansa etal. Journal of Medical Case Reports (2024) 18:118 Introduction Lung cancer is ranked as the most common cause of cancer-related death worldwide. Non-small cell lung cancers (NSCLCs) are currently the most prevalent form, accounting for approximately 80–85% of all lung cancer cases [1]. The majority of patients diagnosed with lung adenocarcinoma are of

FAQs

Why are EGFR-TKIs standard for advanced non-small-cell lung cancer?

EGFR tyrosine kinase inhibitors have established efficacy, particularly for common EGFR mutations. Their targeted activity can produce dramatic clinical responses in activated EGFR-mutant NSCLC.

What EGFR mutation combination was reported in the case?

The patient’s metastatic NSCLC was characterized by a compound EGFR mutation encompassing L858R and S768I.

What treatment was used and what outcomes were observed?

The patient underwent afatinib-based treatment, with overall survival of 51 months and a median progression-free survival of more than 39 months.

Sep 21, 2026

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