Radiographic appearance of leptomeningeal disease in patients with EGFR-mutated non-small-cell lung carcinoma treated with tyrosine kinase inhibitors: a case series
EGFR is frequently mutated in non-small-cell lung carcinomas (NSCLCs). Clinically available tyrosine kinase inhibitors (TKIs) are effective in treating EGFR-mutant NSCLC. In this case series, we present five patients with TKI-treated EGFR-mutated NSCLC who developed leptomeningeal disease (LMD) lacking characteristic imaging findings. All five patients received TKIs prior to development of cytology-confirmed LMD. Clinical signs of LMD preceded radiographic evidence by 2-12 months. T790M, the most common resistance mutation to first-generation EGFR inhibitors, was identified in four cases. These cases illustrate that in patients with EGFR-mutant NSCLC, TKIs may effectively control LMD, creating a lag between onset of symptoms and observation of radiographic findings.
Medical Subject Headings
Aged; Carcinoma, Non-Small-Cell Lung (diagnostic imaging, drug therapy, genetics, pathology); Disease Progression; ErbB Receptors (genetics); Female; Humans; Lung Neoplasms (diagnostic imaging, drug therapy, genetics, pathology); Male; Meningeal Neoplasms (diagnostic imaging, genetics, secondary); Middle Aged; Mutation; Protein Kinase Inhibitors (therapeutic use)
Digital Object Identifier (DOI)
Sener, Ugur; Matin, Nassim; Yu, Helena; Lin, Andrew; Yang, T Jonathan; and Malani, Rachna, "Radiographic appearance of leptomeningeal disease in patients with EGFR-mutated non-small-cell lung carcinoma treated with tyrosine kinase inhibitors: a case series" (2019). Neurology. 1525.