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Afatinib successfully treated leptomeningeal metastasis during erlotinib treatment in a patient with EGFR ‐mutant (Exon18:G719S) lung adenocarcinoma as a second‐line chemotherapy
Author(s) -
Tamiya Motohiro,
Shiroyama Takayuki,
Nishihara Takashi,
Nishida Takuji,
Hayama Manabu,
Tanaka Ayako,
Morishita Naoko,
Suzuki Hidekazu,
Okamoto Norio,
Hirashima Tomonori
Publication year - 2017
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12643
Subject(s) - afatinib , erlotinib , medicine , epidermal growth factor receptor , adenocarcinoma , lung cancer , oncology , cancer research , brain metastasis , chemotherapy , erlotinib hydrochloride , tyrosine kinase , metastasis , cancer , receptor
Exon18 mutations are detected in 3.6% of epidermal growth factor receptor mutations. Exon 18 mutations as driver mutations have higher sensitivities in vitro to second‐generation (G)‐tyrosine kinase inhibitors (TKIs) than to first G‐ and third G‐TKIs at clinically relevant doses. In clinical trial, first G‐TKIs have moderate but insufficient efficacy, and afatinib was more active in uncommon epidermal growth factor receptor mutations. Here, we present a case of a woman who was initially prescribed erlotinib for lung adenocarcinoma with an exon18 mutation. She developed a leptomeningeal metastasis during treatment and was switched to afatinib. Subsequently, her symptoms improved and she is currently treated with maintenance afatinib therapy. This report suggests improved efficacy of afatinib compared to erlotinib for refractory leptomeningeal metastasis in exon18 mutation.