Two Cases of Lung Cancer with Carcinomatous Meningitis in Which Erlotinib Was Effective After Gefitinib Therapy

Abstract

Background. Lung cancer with carcinomatous meningitis has a poor prognosis and it is necessary to establish novel treatments to improve outcome. Erlotinib has not been reported to have been used after gefitinib therapy in a case with brain metastases and carcinomatous meningitis. Case 1. A 70-year-old woman having an adenocarcinoma of the lung (pathological stage IIIB) was treated with gefitinib therapy, but metastases in the adrenal gland and brain were detected. During carboplatin+paclitaxel therapy the brain metastases progressed to carcinomatous meningitis. Case 2. A 58-year-old woman having an adenocarcinoma of the lung (pathological stage IIIB) was treated with gefitinib therapy, but pleural metastases and carcinomatous meningitis were detected. Result. Tumors in both cases had epidermal growth factor receptor (EGFR) gene mutations. Erlotinib therapy improved symptoms and laboratory findings of brain metastases and carcinomatous meningitis. Conclusion. Our result suggested that erlotinib therapy should be effective for carcinomatous meningitis from lung cancer patients with EGFR gene mutation.