Progressive brain metastases in an EGFR mutated adenocarcinoma of the lung: Response to gefitinib after progression on erlotinib

We report a case of a 59-year-old woman with brain metastases from an EGFR mutated adenocarcinoma of the lung. She was initially treated with erlotinib and two times whole brain radiation therapy. After a second relapse within the CNS the therapy was switched to gefitinib and a partial remission of the brain metastases could be achieved. Our case demonstrates that patients can respond to a switch of the EGFR TKI also within the CNS despite heavy pre-treatment. The article reviews the literature regarding the efficacy of tyrosine kinase inhibitors in brain metastases from lung cancers.