Durable Response to Pulsatile Icotinib for Central Nervous System Metastases from -mutated Non-small Cell Lung Cancer: A Case Report

Overview

Journal World J Clin Cases

Publisher Baishideng Publishing Group

Specialty General Medicine

Date 2020 Feb 13

PMID 32047787

Citations 3

Authors

Hui-Ying Li

Yu Xie

Ting-Ting Yu

Yong-Juan Lin

Zhen-Yu Yin

Affiliations

Soon will be listed here.

Abstract

Background: Central nervous system (CNS) metastases are a catastrophic complication of non-small cell lung cancer (NSCLC), including brain and leptomeningeal carcinomatosis, and are always accompanied by a poor prognosis. Despite the continuous development of existing treatments, the therapy of CNS metastases remains challenging.

Case Summary: We report a patient who was definitively diagnosed with brain and leptomeningeal metastases from NSCLC with a targeted mutation in epidermal growth factor receptor (). A standard dosage of icotinib (125 mg three times daily) was implemented but ineffective. CNS lesions developed despite stable systemic control, so pulsatile icotinib (1125 mg every 3 d) was administered. This new strategy for administration has lasted 25 mo so far, and resulted in complete remission of neurological symptoms, almost vanished lesions, and longer survival with no notable side effects.

Conclusion: This is the first successful example of pulsatile icotinib for treating isolated CNS progression from mutation-positive NSCLC, providing a new alternative for the local treatment of CNS metastases.

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