Targeted therapy for non-small cell lung carcinoma (NSCLC) is a possible treatment option for patients with tumours expressing an activating mutation of the epidermal growth factor receptor (EGFR). Gefitinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that was approved for treatment of EGFR mutation-positive NSCLC in Europe in 2009. In Belgium, gefitinib was only approved as a monotherapy for EGFR mutation-positive NSCLC stage IIIB-IV, whatever the line of treatment. When treatment was initiated, limited data were available relating to the use of TKIs for treating Caucasian patients with EGFR mutation-positive NSCLC. Thus, information on EGFR TKI use, in the real-life clinical setting and particularly in Caucasian patients and patients with brain metastases is still needed. Here, we report the case of a patient with NSCLC and brain metastases being treated with gefitinib.
After twelve months of treatment, the chest and brain scans still showed improvement with lung function normalising and the patient reporting a good quality of life. As this patient was not previously treated with chemotherapy, there is still an opportunity of treating her later, when the tumour becomes resistant to gefinitib, with cisplatinum-pemetrexed. This is still possible because she remains chemotherapy-naive, which is required to request reimbursement in Belgium of that type of chemotherapy. (BELG J MED ONCOL 2012;6:169–175)