Chinese Academy of Medical Sciences & Peking Union Medical College, Cancer Hospital Beijing, China.
Thorac Cancer. 2014 Jan;5(1):38-42. doi: 10.1111/1759-7714.12049. Epub 2014 Jan 2.
Epidermal growth factor-tyrosine kinase inhibitors (EGFR-TKIs) are one of the effective medicines in advanced lung adenocarcinoma leptomeningeal metastasis (LM) treatment in recent years.
This paper reports two cases of advanced lung adenocarcinoma with exon-EGFR19 mutation. LM occurred during gefitinib treatment with an extracranial condition under control. Later, erlotinib was adopted with a recurrent response.
The progression free survival of both patients was over six months and their LM was under control for six and a half and nine months, respectively. LM may be sensitive on different levels to different EGFR-TKIs.
Erlotinib can be used to replace gefitinib if intracranial tumor progress occurs during gefitinib treatment. However, our conclusion still needs to be proven by further clinical research.
近年来，表皮生长因子受体-酪氨酸激酶抑制剂（EGFR-TKIs）是治疗晚期肺腺癌脑膜转移（LM）的有效药物之一。
本文报告了两例晚期肺腺癌伴外显子 EGFR19 突变患者。在颅内情况得到控制的情况下，吉非替尼治疗期间发生 LM，随后改用厄洛替尼，再次出现缓解。
两名患者的无进展生存期均超过 6 个月，其 LM 分别得到控制达 6 个半月和 9 个月。不同的 EGFR-TKIs 对 LM 可能有不同程度的敏感性。
如果吉非替尼治疗期间颅内肿瘤进展，可以用厄洛替尼替代吉非替尼。然而，我们的结论仍需要进一步的临床研究来证实。
