Erlotinib May be More Effective for Central Nervous Metastasis of Lung Adenocarcinoma Than Gefitinib Because of the Difference in the Clinical Regimes

Yumiko Imahashi, Naoko Shinmura, Daijiro Nabeya, Kyoko Inui, Takashi Ueji, Mio Hayakawa, Kenichiro Otani, Kyoko Yagyu, Takao Kamimori, Hiroshi Fujiwara


A 54-year-old woman with lung adenocarcinoma which has EGFR point mutation at exon 21 initially improved by administration of gefitinib. Lung lesions responded to gefitinib at 250 mg, but central nervous system lesions, such as carcinomatous meningitis and brain metastasis occurred. The therapy was changed from gefitinib to erlotinib at 150 mg, resulting in remarkable improvement of carcinomatous meningitis and brain metastasis improved dramatically. We hypothesized that the effective concentration of the clinical dose of erlotinib in the CSF is higher than that of gefitinib.

J Med Cases. 2011;2(5):190-193


Erlotinib; EGFR; Gefitinib; Carcinomatous meningitis; Clinical dose

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