Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2020; 8(2): 370-376
Published online Jan 26, 2020. doi: 10.12998/wjcc.v8.i2.370
Durable response to pulsatile icotinib for central nervous system metastases from EGFR-mutated non-small cell lung cancer: A case report
Hui-Ying Li, Yu Xie, Ting-Ting Yu, Yong-Juan Lin, Zhen-Yu Yin
Hui-Ying Li, Yu Xie, Ting-Ting Yu, Yong-Juan Lin, Zhen-Yu Yin, Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
Author contributions: Yin ZY designed the report; Xie Y, Yu TT, and Lin YJ collected the patient’s clinical data; Li HY analyzed the data and wrote the paper; Yin ZY revised the manuscript; all authors have read and approve the final manuscript.
Supported by the Key Project of Nanjing Health Bureau, No. ZKX16031; the Healthcare Project of Nanjing Science and Technology Committee, No. 201715020; the Medical Key Science and Technology Development Project of Nanjing, No. ZKX18014; the Cadre Health Care Project of Jiangsu Province, No. BJ18006; and the Cancer Research Funding of CSCO-Hausen, No. Y-HS2019-5.
Informed consent statement: Written informed consent was obtained from the patient and his next-of-kin regarding the publication of the case details and associated images.
Conflict-of-interest statement: The author reports no conflicts of interest in this work.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhen-Yu Yin, PhD, Attending Doctor, Department of Geriatric Oncology, Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, No. 321, Zhongshan Road, Nanjing 210008, Jiangsu Province, China. lihuiying@njglyy.com
Received: October 11, 2019
Peer-review started: October 11, 2019
First decision: December 4, 2019
Revised: December 6, 2019
Accepted: December 22, 2019
Article in press: December 22, 2019
Published online: January 26, 2020
Core Tip

Core tip: Central nervous system (CNS) metastases are a catastrophic complication of non-small cell lung cancer (NSCLC) and always accompanied by a poor prognosis. We report a patient who was diagnosed with CNS metastases from NSCLC with a targeted mutation in epidermal growth factor receptor. A standard dosage of icotinib (125 mg three times daily) was implemented but ineffective. So pulsatile icotinib (1125 mg every 3 d) was administered. This new strategy for administration resulted in complete remission of neurological symptoms, almost vanished lesions, and longer survival without notable side effects, providing a new alternative for the treatment of CNS metastases.