Leptomeningeal Carcinomatosis in Non–Small-Cell Lung Cancer Patients: Impact on Survival and Correlated Prognostic Factors

Lee, Su Jin; Lee, Jung Il; Nam, Do Hyun; Ahn, Yong-Chan; Han, Jung Ho; Sun, Jong Mu; Ahn, Jin Seok; Park, Keunchil; Ahn, Myung Ju

doi:10.1097/jto.0b013e3182773f21

Cited by 161 publications

(169 citation statements)

References 26 publications

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“…3,6,[8][9][10][12][13][14][15][16][17][18] Cerebral Symptoms Cerebral symptoms include headache, dizziness/vertigo, confusion, fatigue, gait instability, aphasia, altered mental status, seizure (although rare), hemiparesis, and numbness. 16,19,20 Of these, headache is the most common among all 3 anatomical areas of the CNS. 16,19,20 These symptoms are attributed to high intracranial pressure and may be associated with papilledema.…”

Section: Pathogenesis Of Symptomsmentioning

confidence: 99%

Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

Rigakos¹,

Liakou²,

Felipe

et al. 2017

Cancer Control

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Section: Pathogenesis Of Symptomsmentioning

confidence: 99%

Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

Rigakos¹,

Liakou²,

Felipe

et al. 2017

Cancer Control

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“…However, cytotoxic drugs cannot penetrate the blood-brain barrier at effective concentrations; moreover, it is difficult to use chemotherapy in many cases because poor PS of the CM patients. While, there have been reports of successful use of TKIs in CM patients with EGFR mutations [24][25][26][27][28] . Of the 25 CM patients with EGFR mutations identified in the present study, 20 received whole brain radiotherapy before or after the onset of CM (Table 3), and 14 received erlotinib after diagnosis of CM.…”

Section: Discussionmentioning

confidence: 99%

Carcinomatous meningitis and <i>EGFR</i> mutation

Ishikawa

Yamazaki

Mio

et al. 2015

Ann. Cancer Res. Therap.

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Background: Carcinomatous meningitis (CM) in non-small cell lung cancer (NSCLC) has no standard treatment and poor prognosis, with a median survival of 4-9 weeks. Recently, NSCLC subgroups with driver mutations were identified, with mutation of epidermal growth factor receptor gene (EGFR) being the most frequent. This retrospective study investigated the frequency and characteristics of CM in EGFR-mutated patients. Methods: From April 2007 to June 2013, consecutive NSCLC patients were screened for EGFR mutations using the PNA-LNA PCR Clamp in one institution. Diagnosis of CM was based on the presence of malignant cells in cerebrospinal fluid and/or MRI detection of leptomeningeal enhancement. Incidence and clinical features of CM patients were investigated from medical records. Results: Of 1343 NSCLC patients, 387 (28.8%) harboring EGFR mutations. Thirty-five patients (2.6%) developed CM; the rate of CM in EGFR-mutated patients (25/387, 6.46%) was significantly higher than in patients lacking the mutations (10/956, 1.04%; p < 0.01). Multiplex logistic analysis indicated strong associations between CM and EGFR mutation (p < 0.0001), brain metastasis (p < 0.0001) and non-squamous cell carcinoma histology (p = 0.026). Conclusions: NSCLC patients with EGFR mutations are more likely to develop CM than those with wild EGFR.

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“…Considering the nature of LMC, which often causes a poor PS (19), chest physicians should consider the use of afatinib, even for a short period, for patients with LMC derived from firstgeneration EGFR-TKI-resistant adenocarcinoma, regardless of the PS score and the presence of the T790M mutation in the extracranial lesions. Nevertheless, our results should be confirmed in a future prospective study.…”

Section: Discussionmentioning

confidence: 99%

Promising Effects of Afatinib on Leptomeningeal Carcinomatosis Derived from Erlotinib-resistant Lung Adenocarcinoma

et al. 2016

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We herein report a case of a 67-year-old woman previously treated with erlotinib for adenocarcinoma with an epidermal growth factor receptor (EGFR) mutation in exon 19, which rapidly developed to progressive symptomatic leptomeningeal carcinomatosis. The primary tumor and lung metastases also worsened and the performance status (PS) score declined to 3. With a re-biopsy from the pulmonary metastases, the T790M mutation was detected by the cobas EGFR mutation test, but not the cycleave test, although an exon 19 deletion was detected by both of the tests. A week after afatinib initiation, the neurological symptoms disappeared and the PS improved to 1 with a radiological response in all disease sites. Chest physicians should consider the use of afatinib for patients with leptomeningeal carcinomatosis from 1st-generation EGFR-TKI resistant adenocarcinoma, regardless of the PS score and the presence of the T790M mutation in the extracranial lesion.

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Leptomeningeal Carcinomatosis in Non–Small-Cell Lung Cancer Patients: Impact on Survival and Correlated Prognostic Factors

Cited by 161 publications

References 26 publications

Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

Clinical Presentation, Diagnosis, and Radiological Findings of Neoplastic Meningitis

Carcinomatous meningitis and <i>EGFR</i> mutation

Promising Effects of Afatinib on Leptomeningeal Carcinomatosis Derived from Erlotinib-resistant Lung Adenocarcinoma

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