Gefitinib treatment for carcinomatous meningitis in non-small cell lung cancer

• Published in: Revue des maladies respiratoires Vol. 23; no. 2 Pt 1; p. 149
• Main Authors: Chouahnia, K, Brechot, J-M, Des-Guetz, G, Saintigny, P, Morere, J-F, Breau, J-L
• Format: Journal Article
• Language: French
• Published: France 01.04.2006
• Subjects: Adenocarcinoma, Bronchiolo-Alveolar - drug therapy; Adenocarcinoma, Bronchiolo-Alveolar - pathology; Adenocarcinoma, Bronchiolo-Alveolar - radiotherapy; Antineoplastic Agents - therapeutic use; Carboplatin - administration & dosage; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - radiotherapy; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Combined Modality Therapy; Cranial Irradiation; Female; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Meningitis - drug therapy; Meningitis - radiotherapy; Middle Aged; Neoplasm Proteins - antagonists & inhibitors; Paclitaxel - administration & dosage; Palliative Care; Pneumonectomy; Protein Kinase Inhibitors - therapeutic use; Quinazolines - therapeutic use; Receptor, Epidermal Growth Factor - antagonists & inhibitors; Vinblastine - administration & dosage; Vinblastine - analogs & derivatives
• ISSN: 0761-8425
• DOI: 10.1016/S0761-8425(06)71478-4

Carcinomatous meningitis is a major complication in Non Small Cell Lung Cancer (NSCLC). Despite treatment with radiotherapy alone or in combination with intrathecal and systemic chemotherapy, its prognosis remains poor. We report a case of a female non-smoker with adenocarcinoma with bronchoalveolar features presenting with carcinomatous meningitis three years after the diagnosis of her primary tumour. Gefitinib treatment was proposed because of the persistence of meningitic symptoms despite cranial irradiation. Clinical response was observed within 3 weeks and lasted for 9 months. Gefitinib may be effective in treating carcinomatous meningitis complicating NSCLC and should be considered in this situation given the absence of effective alternatives.