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Julie Vanderpoel, Bruno Emond, Isabelle Ghelerter, Katherine Milbers, Marie-Hélène Lafeuille, Patrick Lefebvre, and Lorie A Ellis

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Luxi Chen, John Davelaar, Srinivas Gaddam, Kambiz Kosari, Nicholas Nissen, George Chaux, Christopher Lee, Eric Vail, Andrew Hendifar, Jun Gong, Karen Reckamp, and Arsen Osipov

Pancreatic metastasis of primary lung adenocarcinoma is a rare occurrence, accounting for <0.3% of all pancreatic malignancies. Given that the prognosis and treatment options for primary pancreatic cancer differ greatly from pancreatic metastases from a primary site, an accurate diagnosis is critical. This report presents a unique case of a 65-year-old man who was admitted with significant unintentional weight loss, fatigue, abdominal pain, and jaundice, and found to have a pancreatic mass initially thought to be primary pancreatic adenocarcinoma and subsequently diagnosed as an EGFR-mutated lung adenocarcinoma with metastases to the pancreas via early application of next-generation sequencing (NGS). The use of NGS early in the patient’s clinical course not only changed the treatment strategy but also drastically altered the prognosis. Although metastatic pancreatic adenocarcinoma has a poor prognosis and survival rate, treatment of EGFR-mutated non–small cell lung cancer with EGFR tyrosine kinase inhibitors is associated with high response rates. Importantly, our case demonstrates that timely application of NGS very early in the disease course is paramount to the diagnosis, management, and prognosis of solid malignancies.

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Dipesh Uprety and David E. Marinier

– 450 . 10. Lee CK Man J Lord S . Checkpoint inhibitors in metastatic EGFR-mutated non-small cell lung cancer: a meta-analysis . J Thorac Oncol 2017 ; 12 : 403 – 407 . 11. Gainor JF Shaw AT Sequist LV . EGFR mutations and ALK

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Jarushka Naidoo

inhibitors in metastatic EGFR-mutated non–small cell lung cancer—a meta-analysis . J Thorac Oncol 2017 ; 12 : 403 – 407 . 10.1016/j.jtho.2016.10.007 27765535 10. Skoulidis F , Goldberg ME , Greenawalt DM , STK11/LKB1 mutations and PD-1

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Sanam Loghavi, Mark J. Routbort, Keyur P. Patel, Rajyalakshmi Luthra, Wei-Lien Wang, Russell R. Broaddus, Michael A. Davies, and Alexander J. Lazar

2009 ; 361 : 1018 – 1020 . 11. He Y . Rociletinib in EGFR-mutated non-small-cell lung cancer . N Engl J Med 2015 ; 373 : 578 . 12. Sequist LV Rolfe L Allen AR . Rociletinib in EGFR-mutated non-small-cell lung cancer . N Engl

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Presenters: Jane Yanagawa and Gregory J. Riely

pooled analysis by the LACE Collaborative Group . J Clin Oncol 2008 ; 26 : 3552 – 3559 . 10.1200/JCO.2007.13.9030 6. Wu YL , Tsuboi M , He J , Osimertinib in resected EGFR-mutated non-small-cell lung cancer . N Engl J Med 2020 ; 383

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Presenters: Dara L. Aisner and Gregory J. Riely

. 32047559 4. Wu YL , Tsuboi M , He J , Osimertinib in resected EGFR-mutated non-small-cell lung cancer . N Engl J Med 2020 ; 383 : 1711 – 1723 . 32955177 5. Benayed R , Offin M , Mullaney K , High yield of RNA sequencing for

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Anil K. Rengan and Crystal S. Denlinger

other than acquired kinase domain mutations. Our patient’s robust response to successive FGFR inhibitor therapy was therefore remarkable. As was observed in EGFR -mutated non–small cell lung cancer, 36 we must gain an understanding of which FGFR2

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David S. Ettinger, Douglas E. Wood, Dara L. Aisner, Wallace Akerley, Jessica R. Bauman, Ankit Bharat, Debora S. Bruno, Joe Y. Chang, Lucian R. Chirieac, Thomas A. D’Amico, Thomas J. Dilling, Jonathan Dowell, Scott Gettinger, Matthew A. Gubens, Aparna Hegde, Mark Hennon, Rudy P. Lackner, Michael Lanuti, Ticiana A. Leal, Jules Lin, Billy W. Loo Jr, Christine M. Lovly, Renato G. Martins, Erminia Massarelli, Daniel Morgensztern, Thomas Ng, Gregory A. Otterson, Sandip P. Patel, Gregory J. Riely, Steven E. Schild, Theresa A. Shapiro, Aditi P. Singh, James Stevenson, Alda Tam, Jane Yanagawa, Stephen C. Yang, Kristina M. Gregory, and Miranda Hughes

multiple advanced solid tumors . Cancer Discov 2020 ; 10 : 688 – 701 . 10.1158/2159-8290.CD-19-1014 32213540 21. Wu YL , Tsuboi M , He J , . Osimertinib in resected EGFR-mutated non-small-cell lung cancer . N Engl J Med 2020 ; 383 : 1711