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Durable response to pulsatile icotinib for central nervous system metastases from EGFR-mutated non-small cell lung cancer: A case report.
World J Clin Cases. 2020 Jan 26; 8(2):370-376.WJ

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 (EGFR). 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 EGFR mutation-positive NSCLC, providing a new alternative for the local treatment of CNS metastases.

Authors+Show Affiliations

Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China.Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China. lihuiying@njglyy.com.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32047787

Citation

Li, Hui-Ying, et al. "Durable Response to Pulsatile Icotinib for Central Nervous System Metastases From EGFR-mutated Non-small Cell Lung Cancer: a Case Report." World Journal of Clinical Cases, vol. 8, no. 2, 2020, pp. 370-376.
Li HY, Xie Y, Yu TT, et al. Durable response to pulsatile icotinib for central nervous system metastases from EGFR-mutated non-small cell lung cancer: A case report. World J Clin Cases. 2020;8(2):370-376.
Li, H. Y., Xie, Y., Yu, T. T., Lin, Y. J., & Yin, Z. Y. (2020). Durable response to pulsatile icotinib for central nervous system metastases from EGFR-mutated non-small cell lung cancer: A case report. World Journal of Clinical Cases, 8(2), 370-376. https://doi.org/10.12998/wjcc.v8.i2.370
Li HY, et al. Durable Response to Pulsatile Icotinib for Central Nervous System Metastases From EGFR-mutated Non-small Cell Lung Cancer: a Case Report. World J Clin Cases. 2020 Jan 26;8(2):370-376. PubMed PMID: 32047787.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Durable response to pulsatile icotinib for central nervous system metastases from EGFR-mutated non-small cell lung cancer: A case report. AU - Li,Hui-Ying, AU - Xie,Yu, AU - Yu,Ting-Ting, AU - Lin,Yong-Juan, AU - Yin,Zhen-Yu, PY - 2019/10/11/received PY - 2019/12/06/revised PY - 2019/12/22/accepted PY - 2020/2/13/entrez PY - 2020/2/13/pubmed PY - 2020/2/13/medline KW - Case report KW - Central nervous system metastases KW - EGFR mutation KW - Non-small cell lung cancer KW - Pulsatile icotinib SP - 370 EP - 376 JF - World journal of clinical cases JO - World J Clin Cases VL - 8 IS - 2 N2 - 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 (EGFR). 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 EGFR mutation-positive NSCLC, providing a new alternative for the local treatment of CNS metastases. SN - 2307-8960 UR - https://www.unboundmedicine.com/medline/citation/32047787/Durable_response_to_pulsatile_icotinib_for_central_nervous_system_metastases_from_EGFR_mutated_non_small_cell_lung_cancer:_A_case_report_ L2 - http://www.wjgnet.com/2307-8960/full/v8/i2/370.htm DB - PRIME DP - Unbound Medicine ER -
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