Durable response to pulsatile icotinib for central nervous system metastases from EGFR-mutated non-small cell lung cancer: A case report  

作　　者：Hui-Ying Li Yu Xie Ting-Ting Yu Yong-Juan Lin Zhen-Yu Yin 

机构地区：[1]Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School

出　　处：《World Journal of Clinical Cases》2020年第2期370-376,共7页世界临床病例杂志

基　　金：Supported by the Key Project of Nanjing Health Bureau,No.ZKX16031;the Healthcare Project of Nanjing Science and Technology Committee,No.201715020;the Medical Key Science and Technology Development Project of Nanjing,No.ZKX18014;the Cadre Health Care Project of Jiangsu Province,No.BJ18006;the Cancer Research Funding of CSCO-Hausen,No.Y-HS2019-5

摘　　要：BACKGROUND Central nervous system(CNS) metastases are a catastrophic complication of nonsmall cell lung cancer(NSCLC), including brain and leptomeningeal carcinomatosis, and are always accompanied by a poor prognosis. Despite the continuous development of existing treatments, the therapy of CNS metastases remains challenging.CASE SUMMARY We report a patient who was definitively diagnosed with brain and leptomeningeal metastases from NSCLC with a targeted mutation in epidermal growth factor receptor(EGFR). A standard dosage of icotinib(125 mg three times daily) was implemented but ineffective. CNS lesions developed despite stable systemic control, so pulsatile icotinib(1125 mg every 3 d) was administered. This new strategy for administration has lasted 25 mo so far, and resulted in complete remission of neurological symptoms, almost vanished lesions, and longer survival with no notable side effects.CONCLUSION This is the first successful example of pulsatile icotinib for treating isolated CNS progression from EGFR mutation-positive NSCLC, providing a new alternative for the local treatment of CNS metastases.BACKGROUND Central nervous system(CNS) metastases are a catastrophic complication of nonsmall cell lung cancer(NSCLC), including brain and leptomeningeal carcinomatosis, and are always accompanied by a poor prognosis. Despite the continuous development of existing treatments, the therapy of CNS metastases remains challenging.CASE SUMMARY We report a patient who was definitively diagnosed with brain and leptomeningeal metastases from NSCLC with a targeted mutation in epidermal growth factor receptor(EGFR). A standard dosage of icotinib(125 mg three times daily) was implemented but ineffective. CNS lesions developed despite stable systemic control, so pulsatile icotinib(1125 mg every 3 d) was administered. This new strategy for administration has lasted 25 mo so far, and resulted in complete remission of neurological symptoms, almost vanished lesions, and longer survival with no notable side effects.CONCLUSION This is the first successful example of pulsatile icotinib for treating isolated CNS progression from EGFR mutation-positive NSCLC, providing a new alternative for the local treatment of CNS metastases.

关 键 词：Non-small cell lung cancer Central nervous system metastases EGFR mutation Pulsatile icotinib Case report 

分 类 号：R734.2[医药卫生—肿瘤]