Osimertinib Administration as the Primary Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy for Brain Metastasis of De Novo T790M-positive Lung Cancer

Intern Med. 2019 Oct 15;58(20):3029-3031. doi: 10.2169/internalmedicine.3169-19. Epub 2019 Jun 27.

Abstract

A 69-year-old woman underwent left upper lobectomy for left upper lobe lung adenocarcinoma. She later perceived a left visual field defect, and a brain metastasis was detected on head magnetic resonance imaging (MRI). Epidermal growth factor receptor (EGFR) testing identified two separate EGFR mutations: an L858R mutation in exon 21 and a de novo T790M mutation in exon 20. Treatment with osimertinib was started. After one month, head MRI showed that the brain metastasis had shrunk, and the visual field defect had also improved. In this case, first-line osimertinib was effective for treating brain metastasis of de novo T790M-positive lung cancer.

Keywords: brain metastasis; de novo EGFR T790M; lung cancer; osimertinib; primary EGFR-TKI therapy.

Publication types

  • Case Reports

MeSH terms

  • Acrylamides / therapeutic use*
  • Aged
  • Aniline Compounds / therapeutic use*
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / secondary
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / secondary
  • DNA, Neoplasm / genetics
  • ErbB Receptors / genetics
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Magnetic Resonance Imaging
  • Mutation
  • Protein Kinase Inhibitors / pharmacology*

Substances

  • Acrylamides
  • Aniline Compounds
  • DNA, Neoplasm
  • Protein Kinase Inhibitors
  • osimertinib
  • ErbB Receptors