Successful response to first-line treatment with osimertinib for choroidal metastasis from EGFR-mutated non-small-cell lung cancer

Describe the use of osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, as the first-line treatment in a patient with choroidal and central nervous system metastases from EGFR-mutated non-small cell lung cancer. A 68-year-old man presented with an amela...

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Bibliographic Details
Published in:American journal of ophthalmology case reports 2022-06, Vol.26, p.101459, Article 101459
Main Authors: Field, Matthew G., Boldt, H. Culver, Abu Hejleh, Taher, Binkley, Elaine M.
Format: Article
Language:English
Subjects:
Case Report
Choroidal metastasis
EGFR
Epidermal growth factor receptor
Lung adenocarcinoma
Osimertinib
Tyrosine kinase inhibitor
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Summary:Describe the use of osimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, as the first-line treatment in a patient with choroidal and central nervous system metastases from EGFR-mutated non-small cell lung cancer. A 68-year-old man presented with an amelanotic choroidal lesion in the left eye concerning for choroidal metastasis. Systemic evaluation identified widely metastatic adenocarcinoma of the lung with EGFR exon 19 mutation. Within one month of initiating treatment with osimertinib, there was complete resolution of the subretinal fluid over the choroidal lesion and decreased thickness of the lesion. At follow-up after three months of treatment, the lesion was clinically involuted. Positron emission tomography at two months and magnetic resonance imaging of the brain at three months showed significant interval decrease in size and activity of the primary right lung lesion, central nervous system lesions, and other metastatic sites with no new metastatic lesions. After 17 months of follow up, the lesion remained involuted. Osimertinib may be considered as a first-line treatment option in patients with choroidal metastases from an EGFR-mutated non-small cell lung cancer.
ISSN:2451-9936
2451-9936
DOI:10.1016/j.ajoc.2022.101459