Journal
JOURNAL OF NEURO-ONCOLOGY
Volume 99, Issue 2, Pages 283-286Publisher
SPRINGER
DOI: 10.1007/s11060-010-0128-6
Keywords
Leptomeningeal metastases; EGFR; Lung cancer; Erlotinib
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Funding
- Joan's Legacy
- Doris Duke Charitable Foundation
- NIH
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Leptomeningeal metastases (LM) occur in 5-10% of patients with solid tumors and are associated with a dismal prognosis. We describe LM from lung adenocarcinoma harboring a mutation in the epidermal growth factor receptor (EGFR) gene that confers sensitivity to the EGFR tyrosine kinase inhibitors (EGFR-TKIs) erlotinib and gefitinib. The CSF concentration of EGFR-TKIs achieved by standard daily dosing may be insufficient for therapeutic effect. However, intermittent (pulsatile) high dose administration (1000-1500 mg/week) achieves a higher CSF concentration than standard dosing, and successfully controlled LM in this patient.
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