AUTHOR=Miao Zhihua , Mu Tianhao , Liu Longying , Rao Jingjie , Jin Min , Wang Zhizheng , Wang Hui , Lu Chao , Gong Xiaolin , Zheng Dongcai , Zheng Daoming , Li Xin , Li Yingmei , Chen Shifu , Shu Xinhua 

TITLE=Case Report: A Chronological Combination Treatment of Icotinib, Osimertinib, and Crizotinib on Lung Adenocarcinoma Guided by Serial Genetic Tests of Circulating Tumor DNA and Sediment Cell Genomic DNA From Pleural Effusion

JOURNAL=Frontiers in Oncology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.561341

DOI=10.3389/fonc.2020.561341

ISSN=2234-943X

ABSTRACT=<p>Precision medicine has been getting more attention in lung cancer treatment. Here, we report an unusual case of a 71-year-old Chinese male patient with poorly differentiated lung adenocarcinoma with lymph node metastasis. A 5 years' treatment history of this patient is reported. By serial genetic tests of circulating tumor DNA (ctDNA) from peripheral blood and sediment cell genomic DNA (PE-sDNA) from pleural effusion, a novel chronological combination treatment of icotinib, osimertinib, and crizotinib was adopted for the present genetic mutations, including <italic>EGFR</italic> exon 19 deletion, <italic>EGFR</italic> p.T790M, and <italic>MET</italic> amplification.</p>