Response of Leptomeningeal Metastases in EGFR-Mutated Non-Small-Cell Lung Cancer to Afatinib in the Absence of Radiotherapy

Autor: Néstor Llinás-Quintero, David González-Hoyos, Andrés Yepes, Diego A. Herrera, Sebastián Peláez-Arroyave, Carlos Caicedo-Zamudio, Erick Blanco-Daza, Javier Cuello-López
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Case Reports in Oncological Medicine, Vol 2019 (2019)
Druh dokumentu: article
ISSN: 2090-6706
2090-6714
DOI: 10.1155/2019/1939703
Popis: Palliative radiotherapy is currently the medical standard of care for non-small-cell lung cancer (NSCLC) patients with symptomatic CNS and leptomeningeal disease. We report the case of a 62-year-old male patient with EGFR mutation (del19+) NSLC with symptomatic lymph node, bone, CNS, and leptomeningeal metastases. Taking into account on one hand the response to tyrosine kinase inhibitors (TKIs) and on the other hand the short- to medium-term side effects of radiotherapy and the lack of timely availability in our healthcare system, the patient was treated with afatinib (40 mg daily) and exhibited a rapid response with improvement of neurological symptoms. The patient presented partial response of extracranial, CNS, and leptomeningeal lesions at 3, 6, and 12 months of treatment, currently completing 16 months of progression-free survival despite presenting mild dermatological and gastrointestinal toxicities. Afatinib is an effective and safe option in patients with NSLC EGFR mutation del19+ with CNS and leptomeningeal compromise avoiding or delaying radiotherapy and its side effects, especially in countries where there is a lack of access to this kind of therapy.
Databáze: Directory of Open Access Journals
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