OncoTargets and Therapy (Apr 2021)
EGFR (p. G719A+L747V)/EML4-ALK Co-alterations in Lung Adenocarcinoma with Leptomeningeal Metastasis Responding to Afatinib Treatment: A Case Report
Abstract
Zhiqin Lu,1 Xia Wang,1,2 Yuxi Luo,1 Jianping Wei,1 Zhimin Zeng,1,2 Qiang Xiong,1,2 Jing Cai,1,2 Anwen Liu1,2 1Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People’s Republic of China; 2Jiangxi Key Laboratory of Clinical Translational Cancer Research, Nanchang, Jiangxi Province, People’s Republic of ChinaCorrespondence: Jing Cai; Anwen LiuDepartment of Oncology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Street, Nanchang, Jiangxi Province, 360000, People’s Republic of ChinaTel +8615270905381; Tel +8615270905381Email [email protected]; [email protected]: Leptomeningeal metastasis (LM) is a disastrous complication of advanced lung adenocarcinoma (LAC) associated with poor prognosis and rapid deterioration of performance status. The prevalence of epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK) co-alterations in patients with LAC was low. Herein, we report a patient with alterations in both EGFR (p. G719A+L747V) and echinoderm microtubule-associated protein-like ALK (EML4-ALK) fusion and LM who was treated with afatinib. The patient’s clinical symptoms improved, and imaging examination revealed reduced intracranial and extracranial lesions. The progression-free survival (PFS) using afatinib for LM was 25 months, and no severe adverse events occurred.Keywords: afatinib, leptomeningeal metastasis, EGFR, ALK, co-alterations, lung adenocarcinoma
