Uveal metastasis from nonsmall cell lung carcinoma with dramatic response to erlotinib

To report the case of a never-smoker patient whose initial presentation of metastatic nonsmall cell lung carcinoma was with uveal metastasis, which had a dramatic response to targeted biologic therapy with erlotinib (Tarceva) after failing conventional chemotherapy.

Case report. A 43-year-old man with uveal metastasis from nonsmall cell lung adenocarcinoma.

After failing conventional chemotherapy with carboplatin and taxol, with continued documented rapid growth of the uveal metastasis, treatment was initiated with the targeted biologic agent, erlotinib, which is a protein tyrosine kinase inhibitor of the epidermal growth factor receptor(EGFR). Within 3 days of starting erlotinib, shrinkage of the choroidal lesion was noted, and over the course of the next 3 months, the tumor completely and durably disappeared, with vision improving from hand motion to 20/25. The patient is still alive and well after 3 years, on continued daily oral erlotinib treatment.

Erlotinib is a well-tolerated newly available Food and Drug Administration-approved oral targeted biologic agent, which may be beneficial in some patients with uveal metastasis from nonsmall cell lung carcinoma, in which an underlying epidermal growth factor receptor mutation is suspected.