EFFICACY OF EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE KINASE INHIBITOR IN TREATING CHOROIDAL METASTASIS FROM NON-SMALL-CELL LUNG CANCER: A 10-Year Review.

Background/purpose: To describe the clinical characteristics of choroidal metastasis in patients with non-small-cell lung carcinoma and report treatment outcomes following targeted therapy versus conventional radiotherapy and/or chemotherapy.

Methods: A retrospective review was conducted in 2 hospitals in Hong Kong between 2013 and 2023. Outcomes included tumor response and visual function following treatment.

Results: A total of 25 eyes of 21 Chinese patients with choroidal metastasis secondary to metastatic non-small-cell lung carcinoma were identified. The majority of patients were nonsmokers. At the time of diagnosis, 88% of eyes were visually symptomatic with a mean visual acuity of 20/100. There were 52% of tumors locating within the macula. Tyrosine kinase inhibitor monotherapy, tyrosine kinase inhibitor with radiotherapy, and radiotherapy and/or chemotherapy groups were observed to demonstrate similar tumor response from 1 month and comparable ocular progression-free indices. Untreated patients had deteriorated vision without any tumor response. The tyrosine kinase inhibitor monotherapy group achieved the most rapid and differential vision gain than other groups.

Conclusion: Tyrosine kinase inhibitor achieved durable disease control in epidermal growth factor receptor mutation-positive non-small-cell lung carcinoma patients with choroidal metastasis, while improving visual function. Tyrosine kinase inhibitor can be considered as an alternative to conventional orbital radiotherapy or chemotherapy for these patients in view of the rapid visual recovery.