Dual Targeting of the Epidermal Growth Factor Receptor Using Combination of Nimotuzumab and Erlotinib in Advanced Non-Small-Cell Lung Cancer with Leptomeningeal Metastases: A Report of Three Cases

Hongyu Xu, 1 Lin Zhou, 2 You Lu, 2 Xiaomei Su, 1 Peng Cheng, 1 Dong Li, 1 Hui Gao, 1 Hua Li, 1 Weiwei Yuan, 1 Ling Zhang, 1 Tao Zhang 1 1Department of Oncology, The General Hospital of Western Theater Command, Chengdu, People’s Republic of China; 2Department of Thoracic Oncology, West China Hospital, Sichuan University, Chengdu, People’s Republic of ChinaCorrespondence: Tao ZhangDepartment of Oncology, The General Hospital of Western Theater Command, No 270, Rongdu Road, Jin Niu District, Chengdu, Sichuan 610083, People’s Republic of ChinaEmail zhangtao269@126.comAbstract: Leptomeningeal metastases (LM) occur in 3– 5% of patients with advanced non-small-cell lung cancer (NSCLC) and are associated with a dismal prognosis. We report three cases of NSCLC with LM who were treated with the combination of nimotuzumab and erlotinib. Magnetic Resonance Imaging (MRI) evaluation during follow-up showed significant improvement in cancer symptoms and decreased tumor size in all three patients. Grade 3 and 4 toxicities were rarely seen. Based on apparent efficacy of the regimen and fewer side effects, we suggest that nimotuzumab in combination with erlotinib may be a promising option for the treatment of NSCLC with LM.Keywords: leptomeningeal metastases, non-small cell lung cancer, nimotuzumab, erlotinib