Background: While the activity of tyrosine kinase inhibitors as the first line treatment for primary tumors in patients with stage IV non-small cell lung cancer and a positive EGF receptor mutation is well known, little data on the efficacy in controlling cerebral metastases are available.
Case report and results: A 43-year-old woman was diagnosed with non-small cell lung cancer with cerebral and hepatic metastases. Emergency radiation therapy was initiated at the time of diagnosis due to superior vena cava syndrome. However, after she failed to respond to this therapy and in light of a positive EGF receptor mutation, gefitinib was added at a dose of 250 mg/day while continuing radiation to the primary lesion and cervical lymph nodes. She showed a rapid clinical and radiologic response with complete remission of the cerebral metastases 6 weeks after starting gefitinib. No severe toxicity was observed.
Conclusion: This case demonstrates that gefitinib can be given during radiation treatment without significant toxicity. Furthermore, complete remission of cerebral metastases can be achieved with tyrosine kinase inhibitor monotherapy.