High dose weekly erlotinib achieves therapeutic concentrations in CSF and is effective in leptomeningeal metastases from epidermal growth factor receptor mutant lung cancer.

Clarke JL, Pao W, Wu N, Miller VA, Lassman AB
J Neurooncol. 2010 99 (2): 283-6

PMID: 20146086 · PMCID: PMC3973736 · DOI:10.1007/s11060-010-0128-6

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.

MeSH Terms (13)

Adenocarcinoma ErbB Receptors Erlotinib Hydrochloride Female Humans Lung Neoplasms Male Meningeal Neoplasms Middle Aged Mutation Protein Kinase Inhibitors Quinazolines Treatment Outcome

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