{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:15:19Z","timestamp":1777918519597,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,8,31]],"date-time":"2020-08-31T00:00:00Z","timestamp":1598832000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100008240","name":"Department of Health of Hebei Province","doi-asserted-by":"publisher","award":["20190681"],"award-info":[{"award-number":["20190681"]}],"id":[{"id":"10.13039\/501100008240","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tumori"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>It remains controversial whether patients with EGFR-mutant lung adenocarcinoma should stop using epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) after progression during treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report:<\/jats:title>\n                    <jats:p>We report a 35-year-old man with poorly differentiated adenocarcinoma of the left upper lobe and an exon 19 deletion (Ex19Del) mutation found by large-panel next-generation sequencing. The patient underwent video-assisted thoracoscopic surgery 12 months after oral administration of icotinib 125 mg tid, and the left upper lobe and surrounding lymph nodes were removed. Postoperative pathology supported a diagnosis of left upper lobe adenocarcinoma and subcarinal (1\/2), main pulmonary artery window (1\/2), and left hilar (1\/2) lymph node metastases. The EGFR mutations in the residual lesions had disappeared, and Ex19Del mutations were still visible in the mediastinal lymph node metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Spatial heterogeneity of the resistance mechanism may explain why patients who continue to receive EGFR-TKIs in combination with local therapies (e.g., radiotherapy) for progressing lesions may benefit even after progression during EGFR-TKI therapy. The loss of the EGFR mutation allele as a putative resistance mechanism requires additional preclinical and clinical confirmation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0300891620949920","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T02:22:13Z","timestamp":1598926933000},"page":"NP52-NP56","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["A case of different gene mutations in primary and metastatic lesions after EGFR-TKI treatment of lung cancer"],"prefix":"10.1177","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0400-1348","authenticated-orcid":false,"given":"Shaonan","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyan","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guangjie","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6797-6783","authenticated-orcid":false,"given":"Qingyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,8,31]]},"reference":[{"key":"bibr1-0300891620949920","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21551"},{"key":"bibr2-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2017.04.011"},{"key":"bibr3-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70364-X"},{"key":"bibr4-0300891620949920","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1186\/s12885-015-1714-y","volume":"15","author":"Choi YJ","year":"2015","journal-title":"BMC Cancer"},{"key":"bibr5-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.24.7049"},{"key":"bibr6-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1038\/tpj.2016.31"},{"key":"bibr7-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3741"},{"key":"bibr8-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1038\/nature17960"},{"key":"bibr9-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-17-1574"},{"key":"bibr10-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx703"},{"key":"bibr11-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-018-0891-1"},{"key":"bibr12-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-018-2668-7"},{"key":"bibr13-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2013.08.009"},{"key":"bibr14-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2015.4921"},{"key":"bibr15-0300891620949920","first-page":"OF2","volume":"9","author":"Entrectinib OK\u2019d for cancers with NTRK fusions, NSCLC","year":"2019","journal-title":"Cancer Discov"},{"key":"bibr16-0300891620949920","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2020.103011"},{"key":"bibr17-0300891620949920","first-page":"JCO1902630","author":"Chae YK","year":"2020","journal-title":"J Clin Oncol"}],"container-title":["Tumori Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0300891620949920","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0300891620949920","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0300891620949920","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:40:58Z","timestamp":1777660858000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0300891620949920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,31]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1177\/0300891620949920"],"URL":"https:\/\/doi.org\/10.1177\/0300891620949920","relation":{},"ISSN":["0300-8916","2038-2529"],"issn-type":[{"value":"0300-8916","type":"print"},{"value":"2038-2529","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,31]]}}}