Journal of Neuro-Oncology

, Volume 99, Issue 2, pp 283–286

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

  • Jennifer L. Clarke
  • William Pao
  • Nian Wu
  • Vincent A. Miller
  • Andrew B. Lassman
Case Report

DOI: 10.1007/s11060-010-0128-6

Cite this article as:
Clarke, J.L., Pao, W., Wu, N. et al. J Neurooncol (2010) 99: 283. doi:10.1007/s11060-010-0128-6

Abstract

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.

Keywords

Leptomeningeal metastasesEGFRLung cancerErlotinib

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Jennifer L. Clarke
    • 1
    • 2
  • William Pao
    • 3
    • 4
    • 5
  • Nian Wu
    • 6
  • Vincent A. Miller
    • 3
  • Andrew B. Lassman
    • 1
  1. 1.Department of Neurology and Brain Tumor CenterMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Neurological Surgery, Division of Neuro-OncologyUniversity of CaliforniaSan FranciscoUSA
  3. 3.Thoracic Oncology Service, Department of MedicineMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  4. 4.Human Oncology and Pathogenesis ProgramMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  5. 5.Vanderbilt-Ingram Cancer CenterNashvilleUSA
  6. 6.Program in PharmacologySloan-Kettering Institute, Memorial Sloan-Kettering Cancer CenterNew YorkUSA