Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Fukuoka, Japan.
Thorac Cancer. 2021 Jan;12(1):114-116. doi: 10.1111/1759-7714.13712. Epub 2020 Oct 28.
Dacomitinib, a second-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor, is a standard therapeutic option for patients with EGFR-mutant non-small cell lung cancer (NSCLC). However, its efficacy in patients with central nervous system lesions is unclear. Here, we describe a case of EGFR-mutant NSCLC whose neurological symptoms were due to leptomeningeal carcinomatosis that was successfully treated with dacomitinib. After initiation of dacomitinib, the neurological symptoms of the patient were remarkably improved and leptomeningeal dissemination and brain metastases were shown to have regressed on magnetic resonance imaging (MRI) scan. To our knowledge, this is the first report showing the efficacy of dacomitinib in a patient with leptomeningeal carcinomatosis due to EGFR-mutant NSCLC. The current case suggests that dacomitinib is a novel treatment option for patients with EGFR-mutant NSCLC accompanied by central nervous system lesions, even those with symptomatic leptomeningeal carcinomatosis. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: This is the first report showing the efficacy of dacomitinib in a patient with leptomeningeal carcinomatosis due to EGFR-mutant NSCLC. WHAT THIS STUDY ADDS: The current case suggests that dacomitinib is a novel treatment option for patients with EGFR-mutant NSCLC accompanied by CNS lesions, even in those with symptomatic leptomeningeal carcinomatosis.
达可替尼，第二代表皮生长因子受体（EGFR）-酪氨酸激酶抑制剂，是 EGFR 突变型非小细胞肺癌（NSCLC）患者的标准治疗选择。然而，其在中枢神经系统病变患者中的疗效尚不清楚。在此，我们描述了一例 EGFR 突变型 NSCLC 患者，其神经系统症状是由于脑膜转移引起的，用达可替尼治疗后症状得到显著改善，磁共振成像（MRI）扫描显示脑膜播散和脑转移得到缓解。据我们所知，这是首例报告显示达可替尼在 EGFR 突变型 NSCLC 伴中枢神经系统病变患者中脑膜转移中的疗效。本病例提示，达可替尼可能是 EGFR 突变型 NSCLC 伴中枢神经系统病变患者的一种新的治疗选择，即使是有症状性脑膜转移的患者。
研究的显著发现：这是首例报告显示达可替尼在 EGFR 突变型 NSCLC 伴脑膜转移患者中的疗效。
本研究的新增内容：本病例提示，达可替尼可能是 EGFR 突变型 NSCLC 伴中枢神经系统病变患者的一种新的治疗选择，即使是有症状性脑膜转移的患者。
