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  • Case Study
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CNS response after erlotinib therapy in a patient with metastatic NSCLC with an EGFR mutation

Abstract

Background A 73-year-old Asian man with a history of lipidemia, hypertension and myocardial infarction presented with dizziness, decreased appetite, weight loss, nonproductive cough and fatigue. His physical performance status was good, and physical examination was unremarkable except for lower-extremity pitting edema.

Investigations Physical examination, brain MRI, CT scans of the chest, abdomen and pelvis, bone scan, CT scan-guided biopsy, hematoxylin and eosin staining, EGFR mutational analysis, and chest X-ray.

Diagnosis Stage IV non-small-cell lung cancer with brain metastasis.

Management Oral erlotinib 150 mg daily for 10 months and ongoing, and whole-brain irradiation.

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Figure 1: MRI studies before and after erlotinib therapy.
Figure 2: CT scans before and after erlotinib therapy.
Figure 3: Technetium-99m hydroxymethylene diphosphonate bone scans before and after erlotinib therapy.
Figure 4: Hematoxylin and eosin staining of the core-needle-biopsy specimen and fine-needle-biopsy sample of the right upper lobe of the lung mass.

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Acknowledgements

We thank D Baer for critical reading of the manuscript.

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Correspondence to Minggui Pan.

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The authors declare no competing financial interests.

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Pan, M., Santamaria, M. & Wollman, D. CNS response after erlotinib therapy in a patient with metastatic NSCLC with an EGFR mutation. Nat Rev Clin Oncol 4, 603–607 (2007). https://doi.org/10.1038/ncponc0931

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  • DOI: https://doi.org/10.1038/ncponc0931

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