Successful re-treatment with gefitinib for carcinomatous meningitis as disease recurrence of non-small-cell lung cancer
Successful re-treatment with gefitinib for carcinomatous meningitis as disease recurrence of non-small-cell lung cancer
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DOI：
10.1016/j.lungcan.2006.05.016
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发表时间：
2006-09-01
期刊：
影响因子：
5.3
通讯作者：
Hasegawa, Yoshinori
中科院分区：
文献类型：
--
作者：
Hashimoto, Naozumi;Imaizumi, Kazuyoshi;Hasegawa, Yoshinori
我们报告一例妇女与吉非替尼敏感性肺腺癌，谁是成功地用吉非替尼再治疗癌性脑膜炎作为疾病复发。吉非替尼治疗的良好反应部分是由于经支气管肺活检标本中癌细胞中表皮生长因子受体突变的存在，其中外显子18中的E709G和外显子21中的L858R被显示出来。虽然癌性脑膜炎在吉非替尼治疗下得到了很好的控制，但血清癌胚抗原（CEA）水平随着原发肿瘤的再生长和淋巴管癌病的发展而升高。免疫组化结果显示，吉非替尼再次治疗期间肺部病变复发后的活检标本中重新出现CEA产生的癌细胞，但在首次出现时获得的标本中显示很少或没有CEA表达。这些事实可能提示在本病例中癌细胞存在寡克隆的可能性。2006爱思唯尔爱尔兰有限公司版权所有。
We report the case of a woman with gefitinib-sensitive lung adenocarcinoma, who was successfully re-treated with gefitinib for carcinomatous meningitis as the disease recurrence. The good response to gefitinib treatment was supported in part by the existence of epidermal growth factor receptor mutation in carcinoma cells in the specimen obtained from transbronchial lung biopsy, in which E709G in exon 18 and L858R in exon 21 were shown. Although carcinomatous meningitis had been well controlled by the treatment with gefitinib, serum carcinoembryonic antigen (CEA) level increased with re-growth of primary tumor and development of lymphangitic carcinomatosis. Immunohistochemical findings revealed de novo emergence of CEA-producing carcinoma cells in the biopsy specimen taken after recurrence of pulmonary lesion during re-treatment of gefitinib, but revealed little or no CEA expression in the specimen obtained at first presentation. These facts may suggest the possibility of oligo clonality of carcinoma cells in this case. (C) 2006 Elsevier Ireland Ltd. All rights reserved.