Alternating Administration of Osimertinib for Leptomeningitis and Docetaxel Plus Ramucirumab for Lung Adenocarcinoma Resistant to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors: A Case Report

• Published in: Internal medicine (Tokyo, 1992) 1992), 2024-12
• Main Authors: Tomizawa, Haruka, Mouri, Atsuto, Mikoshiba, Satsuki, Tsukamoto, Kasumi, Abe, Yukiko, Oda, Miku, Tsuchiya, Maya, Yamana, Takashi, Suhara, Kozo, Kamimura, Mitsuhiro
• Format: Article
• Language: eng ; jpn
• ISSN: 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.4427-24

Traditionally, leptomeningitis (LM) has been considered untreatable and terminal, but the development of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has significantly improved the prognosis of patients with EGFR mutations. However, non-LM lesions occasionally progress or recur, even when the LM is successfully controlled with EGFR-TKIs, and treatment of such cases remains unclear. We herein report a patient with advanced non-small-cell lung cancer (NSCLC) who was treated with an EGFR-TKI for LM and cytotoxic chemotherapy for EGFR-TKI-resistant pulmonary lesions. The patient survived for almost four years after the diagnosis of LM, suggesting that this treatment may be beneficial in advanced NSCLC with EGFR-TKI-sensitive LM and EGFR-TKI-resistant extracranial lesions.