Effective Treatment With Afatinib of Lung Adenocarcinoma With Leptomeningeal Metastasis Harboring the Exon 18 p.G719A Mutation in the EGFR Gene Was Detected in Cerebrospinal Fluid: A Case Report
Open accessAbstract
Background: In patients with lung adenocarcinoma and leptomeningeal metastases, it remains unknown whether non-classical mutations in the epidermal growth factor receptor (EGFR) gene can be detected in the cerebrospinal fluid (CSF) and how it may be used to design directed therapy. Methods: On April 18, 2018, the Interventional Department of Tianjin Huanhu Hospital admitted a 34-year-old male patient with lung adenocarcinoma and leptomeningeal metastasis. An emergency lateral ventriculoperitoneal shunt was performed to relieve the clinical symptoms of intracranial hypertension. Next-generation sequencing (NGS) of the CFS specimens revealed a mutation in EGFR exon 18 p.G719A, and afatinib was administered. Follow-up showed significantly relieved headache, with significantly reduced soft leptomeningeal abnormal enhancement as revealed by enhanced magnetic resonance imaging and significantly smaller tumors in the left lung by chest computed tomography. Carcinoembryonic antigens (CEA) in cerebrospinal fluid and peripheral blood were significantly reduced. The patient responded well to afatinib, with mild adverse complications. The patient died on October 27, 2019, from respiratory failure as a result of lung infection unrelated to cancer progression. The overall survival (OS) using afatinib was 530 days. Conclusion: CSF can be used as a liquid biopsy for NGS gene detection in patients with lung adenocarcinoma and leptomeningeal metastases. Afatinib exhibits a beneficial effect in patients with lung adenocarcinoma and leptomeningeal metastases harboring the EGFR exon 18 p.G719A mutation.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Structure-function-based grouping identified a larger subgroup of EGFR mutations, PACC mutants, for which second-generation TKIs were more selective than third-generation TKIs.
“While previous studies have shown activity of second-generation TKIs in patients with specific exon 18 mutations33,34, structure–function-based grouping identified a larger subgroup of EGFR mutations, PACC mutants, for which second-generation TKIs were more selective than third-generation TKIs.”
From Structure-based classification predicts drug response in EGFR-mutant NSCLC (2021) · cites this paper as [34]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Clonal heterogeneity and tumor evolution: past, present, and the future
McGranahan, N., & Swanton, C. (2017) · Cell · doi:10.1016/j.cell.2017.01.018 · Cited by 2,840 · see citing works
Yang, J. C.-H., Sequist, L. V., Geater, S. L., Tsai, C.-M., Mok, T. S. K., Schuler, M., Yamamoto, N., Yu, C.-J., Ou, S.-H. I., Zhou, C., et al. (2015) · The Lancet Oncology · doi:10.1016/s1470-2045(15)00026-1 · Cited by 1,002 · cited 2× · see citing works
“Patients with the G719X mutation treated with second-generation EGFR-TKIs exhibited a median PFS >12 months and an objective response rate of 78% (6).”
BackgroundLocal mutational diversity drives intratumoral immune heterogeneity in non-small cell lung cancer
Jia, Q., Wu, W., Wang, Y., Alexander, P. B., Sun, C., Gong, Z., Cheng, J.-N., Sun, H., Guan, Y., Xia, X., et al. (2018) · Nature Communications · doi:10.1038/s41467-018-07767-w · Cited by 483 · see citing works
Schuler, M., Wu, Y.-L., Hirsh, V., O’Byrne, K., Yamamoto, N., Mok, T., Popat, S., Sequist, L. V., Massey, D., Zazulina, V., et al. (2016) · Journal of Thoracic Oncology · doi:10.1016/j.jtho.2015.11.014 · Cited by 361 · see citing works
Li, Y. S., Jiang, B., Yang, J., Zhang, X. C., Zhang, Z., Ye, J. Y., Zhong, W., Tu, H., Chen, H. J., Wang, Z., et al. (2018) · Annals of Oncology · doi:10.1093/annonc/mdy009 · Cited by 299 · see citing works
Hoffknecht, P., Tufman, A., Wehler, T., Pelzer, T., Wiewrodt, R. G., Schütz, M., Serke, M. H., Stöhlmacher-Williams, J., Märten, A., Huber, R. M., et al. (2014) · Journal of Thoracic Oncology · doi:10.1097/jto.0000000000000380 · Cited by 255 · see citing works
Bai, H., Wang, Z., Chen, K., Zhao, J., Lee, J. J., Wang, S., Zhou, Q., Zhuo, M., Mao, L., An, T., et al. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2011.39.3744 · Cited by 199 · see citing works
Self-citationLee, S. J., Lee, J.-I., Nam, D., Ahn, Y. C., Han, J. H., Sun, J., Ahn, J. S., Park, K., & Ahn, M. (2013) · Journal of Thoracic Oncology · doi:10.1097/jto.0b013e3182773f21 · Cited by 194 · see citing works
Hata, A., Katakami, N., Yoshioka, H., Takeshita, J., Tanaka, K., Nanjo, S., Fujita, S., Kaji, R., Imai, Y., Monden, K., et al. (2013) · Cancer · doi:10.1002/cncr.28364 · Cited by 178 · see citing works
Yi, H. G., Kim, H. J., Kim, Y. J., Han, S., Oh, D., Lee, S., Kim, D., Im, S., Kim, T., Kim, C. S., et al. (2008) · Lung Cancer · doi:10.1016/j.lungcan.2008.10.016 · Cited by 125 · see citing works
Lee, E., Keam, B., Kim, D., Kim, T. M., Lee, S., Chung, D. H., & Heo, D. S. (2013) · Journal of Thoracic Oncology · doi:10.1097/jto.0b013e318294c8e8 · Cited by 121 · see citing works
Jiang, B., Li, Y.-S., Guo, W., Zhang, X., Chen, Z., Su, J., Zhong, W., Yang, X., Yang, J., Shao, Y. W., et al. (2017) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-17-0047 · Cited by 121 · see citing works
Preusser, M., Winkler, F., Valiente, M., Manegold, C., Moyal, E. C., Widhalm, G., Tonn, J., & Zielinski, C. C. (2018) · ESMO Open · doi:10.1136/esmoopen-2017-000262 · Cited by 100 · see citing works
Banno, E., Togashi, Y., Nakamura, Y., Chiba, M., Kobayashi, Y., Hayashi, H., Terashima, M., de Velasco, M. A., Sakai, K., Fujita, Y., et al. (2016) · Cancer Science · doi:10.1111/cas.12980 · Cited by 87 · see citing works
Management of Brain Metastases in Epidermal Growth Factor Receptor Mutant Non-Small-Cell Lung Cancer
Kelly, W., Shah, N. J., & Subramaniam, D. S. (2018) · Frontiers in Oncology · doi:10.3389/fonc.2018.00208 · Cited by 86 · see citing works
EGFR mutation status in brain metastases of non-small cell lung carcinoma
Burel‐Vandenbos, F., Ambrosetti, D., Coutts, M., & Pédeutour, F. (2012) · Journal of Neuro-Oncology · doi:10.1007/s11060-012-0990-5 · Cited by 72 · see citing works
Fan, Y., Zhu, X., Xu, Y., Lu, X., Xu, Y., Wang, M., Xu, H., Ding, J., Ye, X., Fang, L., et al. (2017) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-17-1582 · Cited by 67 · see citing works
Huang, R., Xu, X. L., Li, D., Chen, K., Zhan, Q., Ge, M., Zhou, X., Liang, X., & Guan, M. (2019) · Targeted Oncology · doi:10.1007/s11523-019-00645-5 · Cited by 62 · see citing works
Hostile takeover: how tumours hijack pre‐existing vascular environments to thrive
Winkler, F. (2017) · The Journal of Pathology · doi:10.1002/path.4904 · Cited by 50 · see citing works
Ventriculoperitoneal shunt for hydrocephalus caused by central nervous system metastasis
Lee, S. H., Kong, D. S., Seol, H. J., Nam, D., & Lee, J.-I. (2011) · Journal of Neuro-Oncology · doi:10.1007/s11060-010-0512-2 · Cited by 45 · see citing works
Ma, C., Zhang, J., Tang, D., Ye, X., Li, J., Mu, N., Li, Z., Liu, R., Xiang, L., Huang, C., et al. (2020) · Frontiers in Oncology · doi:10.3389/fonc.2020.00224 · Cited by 22 · see citing works
Self-citationTamiya, M., Shiroyama, T., Nishihara, T., Nishida, T., Hayama, M., Tanaka, A., Morishita, N., Suzuki, H., Okamoto, N., & Hirashima, T. (2016) · Asia-Pacific Journal of Clinical Oncology · doi:10.1111/ajco.12643 · Cited by 6 · see citing works
[Research progress of lung cancer with leptomeningeal metastasis].
Ma, C., Jiang, R., Li, J., Wang, B., Sun, L., & Lv, Y. (2014) · Europe PMC (PubMed Central) · doi:10.3779/j.issn.1009-3419.2014.09.10 · Cited by 6 · see citing works
Self-citation[Diagnosis and Treatment of Leptomeningeal Metastasis in Non-small Cell Lung Cancer].
Xu, Y., Li, L., & Wang, M. (2015) · PubMed · doi:10.3779/j.issn.1009-3419.2015.10.05 · Cited by 2 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- [11]Wang Y Li M Hu CP Rare mutation and targeted therapy of EGFR gene in non-small cell lung cancer. Natl Med J China. (2019) 99: 154– 7. 10.3760/cma.j.issn.0376-2491.2019.02.016 · DOI
Cited by
Sorted by citations
Structure-based classification predicts drug response in EGFR-mutant NSCLC
Robichaux, J. P., Le, X., Vijayan, R. S. K., Hicks, J. K., Heeke, S., Elamin, Y. Y., Lin, H. Y., Udagawa, H., Skoulidis, F., Tran, H., et al. (2021) · Nature · doi:10.1038/s41586-021-03898-1 · Cited by 490 · see citing works
Bian, D. J. H., Lazaratos, A.-M., Maritan, S. M., Quaiattini, A., Zeng, Z., Zhu, Z., Sener, U. T., Malani, R., Kim, Y. J., Ichihara, E., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e29668 · Cited by 12 · see citing works
Lu, Z., Wang, X., Luo, Y., Wei, J., Zeng, Z., Xiong, Q., Cai, J., & Liu, A. (2021) · OncoTargets and Therapy · doi:10.2147/ott.s294635 · Cited by 7 · see citing works
- Authors
- Ma, C., Wang, S., Mu, N., Li, J., Liu, M., Li, L., & Jiang, R.
- Affiliations
- Tianjin Huanhu Hospital (CN)
- Corresponding author
- Jiang, Rong
- Venue
- Frontiers in Oncology
- Publisher
- Frontiers Media SA
- Published
- 2020-09-08
- Volume
- 10
- Pages
- 1635-1635
- ISSN
- 2234-943X (ISSN-L)
- PMC
- PMC7506151
- OpenAlex
- W3084380209
- Cited by
- 3
- References
- 24
- Citations by year
- 2024: 1 · 2021: 2
- FWCI
- 0.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Oncology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Brain Metastases and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Keywords
- lung adenocarcinoma, leptomeningeal metastasis, afatinib, cerebrospinal fluid, liquid biopsy, intracranial hypertension, ventriculoperitoneal shunt, carcinoembryonic antigen, targeted therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
