ONCAlert | Upfront Therapy for mRCC
Lung Cancer Case Studies

Case Studies: EGFR-Mutant Non-Small Cell Lung Cancer With Brain Metastases

Corey J. Langer, MD, reviews the appropriateness for treating a patient with stage IV lung adenocarcinoma with EGFR-TKI therapy and discusses practical considerations for managing patients following disease progression.

EGFR-Mutant Non-Small Cell Lung Cancer With Brain Metastases

June 2017

  • A 61-year-old Caucasian woman presented with persistent cough and shortness of breath
  • Patient history:
    • Never smoked
    • Mild hypertension, controlled on diuretic
    • No major cardiovascular disease or diabetes
    • Worked at local jazz club until symptoms forced her to resign
  • Physical exam and imaging:
    • No palpable masses
    • CT reveals multiple tumors in right lung and brain metastases
    • ECOG PS: 1
  • Biopsy and mutation analysis:
    • Adenocarcinoma
    • EGFR exon 19 deletion
    • No ALK rearrangement
  • Started treatment with afatinib 40 mg once daily
    • Developed diarrhea that necessitated dose interruption
    • Recovered and resumed treatment at 30 mg once daily

March 2018

  • Patient remains on afatinib, with no apparent progression
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