Yeungnam Univ J Med.  2016 Jun;33(1):64-67. 10.12701/yujm.2016.33.1.64.

Efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors for patient with leptomeningeal metastasis of epidermal growth factor receptor mutant non-small cell lung cancer

• Lee JS
• Lee KA
• Lee KH
• Moon SY
• Kim IA
• Jeon SJ
• Min JK
• Kim HJ
• Lee KY

• KMID: 2328118
• DOI: http://doi.org/10.12701/yujm.2016.33.1.64

Abstract

We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.

Keyword

Epidermal growth factor receptor; Cerebrospinal fluid; Gefitinib; Erlotinib

MeSH Terms

Adenocarcinoma
Carboplatin
Carcinoma, Non-Small-Cell Lung
Central Nervous System
Cerebrospinal Fluid
Cisplatin
Drug Therapy
Epidermal Growth Factor*
Erlotinib Hydrochloride
Headache
Humans
Lung Neoplasms*
Lung*
Methotrexate
Middle Aged
Nausea
Neoplasm Metastasis*
Paclitaxel
Phosphotransferases*
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor*
Recurrence
Thorax
Vomiting
Carboplatin
Cisplatin
Epidermal Growth Factor
Erlotinib Hydrochloride
Methotrexate
Paclitaxel
Phosphotransferases
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor