Treatment of Choroidal Metastasis from Epidermal Growth Factor Mutant Non-Small Cell Lung Cancer with First-line Osimertinib Therapy

Vu, Anderson N.; Mehta, Urmi; Israelsen, Paul; Ou, Sai‐Hong Ignatius; Browne, Andrew

doi:10.18502/jovr.v17i1.10178

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…Previously, osimertinib was often reported as a second-line therapy [ 4 , 7 , 8 , 11 ], but since the FLAURA trial, osimertinib has been used as a first-line therapy. However, few reports have demonstrated the efficacy of osimertinib as a first-line therapy for metastatic choroidal tumors [ 9 , 10 ]. Field et al [ 9 ] found that choroidal metastases in a patient with NSCLC and exon 19 EGFR and TP53 mutations resolved completely after 3 months of the first-line therapy with osimertinib.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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Effect of the First-Line Therapy with Osimertinib for a Metastatic Choroidal Tumor in Advanced-Stage Lung Cancer: A Case Report

Umeda¹,

Kitamura²,

Yokouchi³

et al. 2023

Case Rep Ophthalmol

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Although the advent of molecular-targeted drugs has improved the prognosis of various cancers, the long-term prognosis and side effects as the first-line therapy for metastatic choroidal tumors remain unclear. We describe a case in which the first-line therapy of osimertinib has shown long-term successful and minimum side effect responses for metastatic choroidal tumors in a patient with advanced-stage lung cancer. The patient was a 62-year-old man who complained of foggy vision and visual field defects in his left eye for 1 month. When he visited his local doctor, a serous retinal detachment was noted in the left eye, and he was referred to our hospital for further examination. The patient had no history of systemic disease. A fundus examination of his left eye showed a slightly elevated choroidal lesion along with the superior retinal vascular arcade. Optical coherence tomography showed a serous retinal detachment around the lesion. Fluorescein angiography showed that the site of the lesion had spotty and mottled hyperfluorescence in the early phase and ring hypofluorescence in the late phase. We suspected a metastatic choroidal tumor and performed a whole-body computed tomography scan, which indicated lung cancer and metastasis to the left iliac bone. The patient was referred to the department of respiratory medicine of our hospital, and after a thorough examination, a diagnosis of lung adenocarcinoma (stage IV-B, epidermal growth factor receptor [EGFR] gene mutation positive) was made. Treatment with osimertinib was initiated, and shrinkage of the primary tumor was observed. The elevated choroidal lesion and serous retinal detachment resolved after 2 months of treatment, and no recurrence was observed during the 20 months of treatment. The use of osimertinib as primary treatment for EGFR mutation-positive lung cancer was found to significantly reduce the size of metastatic choroidal tumors and to have a relatively long-lasting antitumor effect without serious ocular complications.

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Section: Discussion/conclusionmentioning

confidence: 99%

“…Systemic administration of EGFR-TKIs has been reported to be effective for choroidal metastases in EGFR-mutant NSCLC, and the efficacy of osimertinib has recently been reported [4,[7][8][9][10][11]. An attempt to use osimertinib as the first-line drug for choroidal metastasis in EGFR-mutant NSCLC is also under investigation.…”

Section: Introductionmentioning

confidence: 99%

Effect of the First-Line Therapy with Osimertinib for a Metastatic Choroidal Tumor in Advanced-Stage Lung Cancer: A Case Report

Umeda¹,

Kitamura²,

Yokouchi³

et al. 2023

Case Rep Ophthalmol

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Five-Year Follow-Up of Choroidal Metastasis From Lung Adenocarcinoma Harboring Epidermal Growth Factor Receptor (EGFR) Mutation: A Case Report and Literature Review

Nakashima,

Demura,

Tada

et al. 2024

Cureus

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This is a long-term follow-up case report of a 71-year-old man with lung adenocarcinoma and choroidal metastasis harboring an epidermal growth factor receptor mutation. Blurry vision, caused by the choroidal metastasis, improved with first-line treatment with afatinib. Thereafter, osimertinib was administered as a second-line treatment, then chemotherapy containing pemetrexed plus bevacizumab as a third-line treatment. For 61 months, recurrence of choroidal metastasis was absent. Only a few reports of lung cancer with choroidal metastasis provide long-term follow-up of more than five years. Therefore, the clinical course of this patient may provide some insights for long-term management in such cases.

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Treatment of Choroidal Metastasis from Epidermal Growth Factor Mutant Non-Small Cell Lung Cancer with First-line Osimertinib Therapy

Cited by 2 publications

References 15 publications

Effect of the First-Line Therapy with Osimertinib for a Metastatic Choroidal Tumor in Advanced-Stage Lung Cancer: A Case Report

Effect of the First-Line Therapy with Osimertinib for a Metastatic Choroidal Tumor in Advanced-Stage Lung Cancer: A Case Report

Five-Year Follow-Up of Choroidal Metastasis From Lung Adenocarcinoma Harboring Epidermal Growth Factor Receptor (EGFR) Mutation: A Case Report and Literature Review

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