BACKGROUND Central nervous system(CNS) metastases are a catastrophic complication of nonsmall cell lung cancer(NSCLC), including brain and leptomeningeal carcinomatosis, and are always accompanied by a poor prognosis....BACKGROUND Central nervous system(CNS) metastases are a catastrophic complication of nonsmall 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.展开更多
The incidence of metastatic disease in the central nervous system(CNS)is rising.According to current estimates,up to a third of adult cancer patients will suffer from CNS metastasis.Clinical evidence-based data from p...The incidence of metastatic disease in the central nervous system(CNS)is rising.According to current estimates,up to a third of adult cancer patients will suffer from CNS metastasis.Clinical evidence-based data from prospective randomized trials are rare,however,because CNS metastasis patients were often excluded from clinical trial participation.The management of CNS metastasis patients is therefore rather ill-defined and an interdisciplinary challenge.Recent basic and translational science data have begun contributing to a more profound understanding of the molecular mechanisms leading to invasion of tumor cells into the CNS.This report reviews advances,challenges,and perspectives in this field.展开更多
基金Supported by the Key Project of Nanjing Health Bureau,No.ZKX16031the Healthcare Project of Nanjing Science and Technology Committee,No.201715020+2 种基金the Medical Key Science and Technology Development Project of Nanjing,No.ZKX18014the Cadre Health Care Project of Jiangsu Province,No.BJ18006the Cancer Research Funding of CSCO-Hausen,No.Y-HS2019-5
文摘BACKGROUND Central nervous system(CNS) metastases are a catastrophic complication of nonsmall 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.
基金Intramural Funding of the Center for Personalized Medicine(Demonstratorprojekt“CNSMet”).
文摘The incidence of metastatic disease in the central nervous system(CNS)is rising.According to current estimates,up to a third of adult cancer patients will suffer from CNS metastasis.Clinical evidence-based data from prospective randomized trials are rare,however,because CNS metastasis patients were often excluded from clinical trial participation.The management of CNS metastasis patients is therefore rather ill-defined and an interdisciplinary challenge.Recent basic and translational science data have begun contributing to a more profound understanding of the molecular mechanisms leading to invasion of tumor cells into the CNS.This report reviews advances,challenges,and perspectives in this field.
