Good Clinical Response to Erlotinib in a Non-Small Cell Lung Cancer Patient Harboring Multiple Brain Metastases and a Double Active Somatic Epidermal Growth Factor Gene Mutation.
Good Clinical Response to Erlotinib in a Non-Small Cell Lung Cancer Patient Harboring Multiple Brain Metastases and a Double Active Somatic Epidermal Growth Factor Gene Mutation.
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DOI：
10.1159/000310830
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发表时间：
2010-04-22
影响因子：
0.8
通讯作者：
Mishima M
中科院分区：
文献类型：
--
作者：
Masago K;Togashi Y;Fukudo M;Terada T;Irisa K;Sakamori Y;Fujita S;Kim YH;Mio T;Inui KI;Mishima M
最近，两种靶向表皮生长因子受体（EGFR）的小分子激酶抑制剂（TKI）已被证明在治疗非小细胞肺癌中有效。然而，尚不清楚外显子21中L 858 R的EGFR双激活突变和外显子19中的框内缺失是否是EGFR-TKI有效性的预测因子。我们首次报告了一例伴有中枢神经系统转移的非小细胞肺癌患者，该患者携带罕见的EGFR双激活突变，对厄洛替尼表现出良好的临床反应，尽管他的体能状态不佳，因为吞咽是不可能的。因此，我们认为，厄洛替尼可能成为治疗中枢神经系统转移的情况下，即使性能状态差的选择。
Recently, 2 small molecule kinase inhibitors (TKIs), targeting epidermal growth factor receptor (EGFR), have proven effective in the treatment of non-small cell lung cancer. However, it is unknown whether the EGFR double activating mutation of L858R in exon 21 and the in-frame deletion in exon 19 is a predictor of the effectiveness of EGFR-TKIs. We report for the first time a case of non-small cell lung cancer with central nervous system metastases harboring a rare EGFR double activating mutation who showed a good clinical response to erlotinib, regardless of his poor performance status, as swallowing is not possible. Therefore, we suggest that erlotinib may become a therapeutic choice in cases of central nervous system metastases even with poor performance status.