厄洛替尼治疗脑脊液检测EGFR敏感突变的肺腺癌一例

BACKGROUND AND OBJECTIVE: One of the most ofen distance metastasis site of non-small cell lung cancer (NSCLC) is brain and the standard treatment of brain metastasis was radiotheraphy including whole brain irradiation (WBI) and stereotactic radiotherapy (SRT). It has been reported that epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) had the active response in brain metastasis of lung cancer. In the present study, we reported one case of EGFR 19el in cerebrospinal fluid tested by ARMS got partial response given erlotinib. METHODS: Cerebrospinal fluid was collected through lumbar puncture, then cast-off cells and EGFR mutation was analysed. Erlotinib was given with dose of 150 mg, qd. Objective response was evaluated by Response Evaluation Criteriation in Solid Tumours (RECIST) v1.1 and adeverse events were evaluated according to Common Terminology Criteria for Adverse Events v4.0 (CTC AE v4.0). RESULTS: Heterocyst cells were found in cerebrospinal fluid and EGFR mutation was tested as 19del. Te patient achieved partial response (PR) of brain metastasis and the effective response in lung was stable disease (SD) afer 4 weeks of erlotinib. Te progression-free survival (PFS) and overall survival (OS) of brain metastasis was 10.5 months and 11 months respectively. Te main adverse event was rash (Grade Ⅰ). CONCLUSION: It was feasible to test EGFR mutation in cerebrospinal fluid and the combination of erlotinib with chemotheraphy would be an appropriate choice to those lung cancer patients who had brain metastasis harboring EGFR sensitive mutation.