Durable response to osimertinib in EGFR mutated T790M wildtype non-small cell lung cancer with leptomeningeal metastases: A case report

被引:12
作者
Chalmers, Anna [1 ]
Jensen, Leif [1 ]
Akerley, Wallace [1 ]
机构
[1] Univ Utah, Huntsman Canc Inst, Dept Internal Med, Div Oncol, 2000 Cir Hope Dr, Salt Lake City, UT 84112 USA
关键词
Non-small cell lung cancer; Leptomeningeal metastases; Osimertinib; Epidermal growth factor receptor; CARCINOMATOSIS; ERLOTINIB; AZD9291; NSCLC; TKIS;
D O I
10.1016/j.lungcan.2017.10.009
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
In patients with non-small cell lung cancer (NSCLC) progression with leptomeningeal (LM) metastases is a catastrophic event with limited treatment options. We report a patient who developed leptomeningeal disease while on front-line erlotinib. High-dose tyrosine kinase inhibitor was started but ineffective. She was transitioned to third-generation TKI osimertinib, despite lacking a T790M mutation, and responded with complete resolution of symptoms and malignant cytology in the cerebrospinal fluid (CSF). Recent phase one data and our case indicate osimertinib should be viewed as a best practice for treatment of LM disease in epidermal growth factor receptor (EGFR) mutated NSCLC regardless of T790M status.
引用
收藏
页码:68 / 69
页数:2
相关论文
共 12 条
[1]  
[Anonymous], J CLIN ONCOL S
[2]   Preclinical Comparison of Osimertinib with Other EGFR-TKIs in EGFR-Mutant NSCLC Brain Metastases Models, and Early Evidence of Clinical Brain Metastases Activity [J].
Ballard, Peter ;
Yates, James W. T. ;
Yang, Zhenfan ;
Kim, Dong-Wan ;
Yang, James Chih-Hsin ;
Cantarini, Mireille ;
Pickup, Kathryn ;
Jordan, Angela ;
Hickey, Mike ;
Grist, Matthew ;
Box, Matthew ;
Johnstrom, Peter ;
Varnas, Katarina ;
Malmquist, Jonas ;
Thress, Kenneth S. ;
Janne, Pasi A. ;
Cross, Darren .
CLINICAL CANCER RESEARCH, 2016, 22 (20) :5130-5140
[3]   Symptomatic leptomeningeal metastasis improvement with nivolumab in advanced non-small cell lung cancer patient [J].
Gion, Maria ;
Remon, Jordi ;
Caramella, Caroline ;
Soria, Jean-Charles ;
Besse, Benjamin .
LUNG CANCER, 2017, 108 :72-74
[4]   Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial [J].
Goldberg, Sarah B. ;
Gettinger, Scott N. ;
Mahajan, Amit ;
Chiang, Anne C. ;
Herbst, Roy S. ;
Sznol, Mario ;
Tsiouris, Apostolos John ;
Cohen, Justine ;
Vortmeyer, Alexander ;
Jilaveanu, Lucia ;
Yu, James ;
Hegde, Upendra ;
Speaker, Stephanie ;
Madura, Matthew ;
Ralabate, Amanda ;
Rivera, Angel ;
Rowen, Elin ;
Gerrish, Heather ;
Yao, Xiaopan ;
Chiang, Veronica ;
Kluger, Harriet M. .
LANCET ONCOLOGY, 2016, 17 (07) :976-983
[5]   "Pulsatile" high-dose weekly erlotinib for CNS metastases from EGFR mutant non-small cell lung cancer [J].
Grommes, Christian ;
Oxnard, Geoffrey R. ;
Kris, Mark G. ;
Miller, Vincent A. ;
Pao, William ;
Holodny, Andrei I. ;
Clarke, Jennifer L. ;
Lassman, Andrew B. .
NEURO-ONCOLOGY, 2011, 13 (12) :1364-1369
[6]   AZD9291 in EGFR Inhibitor-Resistant Non-Small-Cell Lung Cancer [J].
Jaenne, Pasi A. ;
Yang, James Chih-Hsin ;
Kim, Dong-Wan ;
Planchard, David ;
Ohe, Yuichiro ;
Ramalingam, Suresh S. ;
Ahn, Myung-Ju ;
Kim, Sang-We ;
Su, Wu-Chou ;
Horn, Leora ;
Haggstrom, Daniel ;
Felip, Enriqueta ;
Kim, Joo-Hang ;
Frewer, Paul ;
Cantarini, Mireille ;
Brown, Kathryn H. ;
Dickinson, Paul A. ;
Ghiorghiu, Serban ;
Ranson, Malcolm .
NEW ENGLAND JOURNAL OF MEDICINE, 2015, 372 (18) :1689-1699
[7]   High-dose erlotinib for refractory leptomeningeal metastases after failure of standard-dose EGFR-TKIs [J].
Kawamura, Takahisa ;
Hata, Akito ;
Takeshita, Jumpei ;
Fujita, Shiro ;
Hayashi, Michio ;
Tomii, Keisuke ;
Katakami, Nobuyuki .
CANCER CHEMOTHERAPY AND PHARMACOLOGY, 2015, 75 (06) :1261-1266
[8]   Leptomeningeal Metastases in Patients with NSCLC with EGFR Mutations [J].
Li, Yang-Si ;
Jiang, Ben-Yuan ;
Yang, Jin-Ji ;
Tu, Hai-Yan ;
Zhou, Qing ;
Guo, Wei-Bang ;
Yan, Hong-Hong ;
Wu, Yi-Long .
JOURNAL OF THORACIC ONCOLOGY, 2016, 11 (11) :1962-1969
[9]   Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors for Non-Small-Cell Lung Cancer Patients with Leptomeningeal Carcinomatosis [J].
Liao, Bin-Chi ;
Lee, Jih-Hsiang ;
Lin, Chia-Chi ;
Chen, Ya-Fang ;
Chang, Chin-Hao ;
Ho, Chao-Chi ;
Shih, Jin-Yuan ;
Yu, Chong-Jen ;
Yang, James Chih-Hsin .
JOURNAL OF THORACIC ONCOLOGY, 2015, 10 (12) :1754-1761
[10]   High efficacy of third generation EGFR inhibitor AZD9291 in a leptomeningeal carcinomatosis model with EGFR-mutant lung cancer cells [J].
Nanjo, Shigeki ;
Ebi, Hiromichi ;
Arai, Sachiko ;
Takeuchi, Shinji ;
Yamada, Tadaaki ;
Mochizuki, Satsuki ;
Okada, Yasunori ;
Nakada, Mitsutoshi ;
Murakami, Takashi ;
Yano, Seiji .
ONCOTARGET, 2016, 7 (04) :3847-3856