Response of Intracranial Metastases to Erlotinib Therapy

Brain metastases are a common occurrence in non–small-cell lung cancer (NSCLC). The standard treatment is radiation therapy with or without resection, but chemotherapy is only modestly palliative for recurrence within the brain. We describe a 60-year-old nonsmoking Native American woman who presented with left-sided weakness due to a stage IV adenocarcinoma of the lung with multiple brain metastases. The patient received whole-brain radiotherapy (33 Gy in 11 fractions) with resolution of her symptoms, but deferred subsequent chemotherapy. Within 3 months, she became symptomatic again with vertigo, anorexia, and a decrease in her performance