Objective To report the diaynosis and afatinib treatment of a patient with leptomeningeal metastasis of lung adenocarcinoma with epidermal growth factor receptor (EGFR) exon18:G719A mutation, detected in cerebrospinal fluid. Methods Cerebrospinal fluid specimens were obtained by lumbar puncture. EGFR mutation status was detected by next-generation sequencing (NGS) method. Afatinib molecular targeted drug therapy was given after positive results were obtained. Results The cerebrospinal fluid EGFR gene test of the patient suggested exon18:G719A mutation. After 8 weeks of afatinib treatment, chest CT showed that the lung lesions were smaller than before, and head MRI showed no obvious intracranial changes. The review indicated that the patient's tumor condition was stable and he had taken the medicine for 55 weeks. The main adverse drug reaction was rash (Grade 1). ConclusionsEGFR mutation in cerebrospinal fluid detection of patients with leptomeningeal metastasis of lung adenocarcinoma can guide the clinical treatment strategy. Afatinib in treating leptomeningeal metastasis of lung adenocarcinoma accompanied by EGFR gene exon18:G719A mutation has definite clinical efficacy and is tolerable.
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