EGFR (p. G719A+L747V)/EML4-ALK Co-alterations in Lung Adenocarcinoma with Leptomeningeal Metastasis Responding to Afatinib Treatment: A Case Report

Zhiqin Lu; Xia Wang; Yuxi Luo; Jianping Wei; Zhimin Zeng; Qiang Xiong; Jing Cai; Anwen Liu

doi:10.2147/OTT.S294635

EGFR (p. G719A+L747V)/EML4-ALK Co-alterations in Lung Adenocarcinoma with Leptomeningeal Metastasis Responding to Afatinib Treatment: A Case Report

Onco Targets Ther. 2021 Apr 23;14:2823-2828. doi: 10.2147/OTT.S294635. eCollection 2021.

Authors

Zhiqin Lu¹, Xia Wang^{1

2}, Yuxi Luo¹, Jianping Wei¹, Zhimin Zeng^{1

2}, Qiang Xiong^{1

2}, Jing Cai^{1

2}, Anwen Liu^{1

2}

Affiliations

¹ Department of Oncology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, People's Republic of China.
² Jiangxi Key Laboratory of Clinical Translational Cancer Research, Nanchang, Jiangxi Province, People's Republic of China.

Abstract

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: ALK; EGFR; afatinib; co-alterations; leptomeningeal metastasis; lung adenocarcinoma.

Publication types

Case Reports