WCLC 2025 - Posters & ePosters-EP.08.50 Excellent Response to Osimertinib-Based Regimens in Choroidal Metastasis in Patients With EGFR Exon 19 Deleted Non-Small Cell Lung Cancer a Case Series

EP.08.50 Excellent Response to Osimertinib-Based Regimens in Choroidal Metastasis in Patients With EGFR Exon 19 Deleted Non-Small Cell Lung Cancer a Case Series

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This case series reports on two patients with metastatic non-small cell lung cancer (NSCLC) harboring EGFR exon 19 deletions who developed symptomatic choroidal metastases leading to vision loss. Choroidal metastasis in NSCLC is a rare but serious complication affecting vision.<br /><br />Both patients were treated with osimertinib, a third-generation EGFR tyrosine kinase inhibitor (TKI) approved as first-line therapy for NSCLC with exon 19 deletions or L858R mutations. <br /><br />In Case 1, a 66-year-old male presented with right eye vision loss (20/200) due to a 6x6 mm choroidal mass and systemic metastases (liver, bone). MRI confirmed thickening in the posterior globe. Blood next-generation sequencing revealed an exon 19 EGFR deletion. He received osimertinib 80 mg daily as first-line systemic therapy with palliative intent. After one month, his visual acuity improved to 20/30, with complete resolution of subretinal fluid and shrinkage of the choroidal lesion, indicating effective disease control with osimertinib alone.<br /><br />In Case 2, a 67-year-old female initially receiving chemotherapy for NSCLC developed worsening vision in the left eye. MRI showed nodular thickening of the choroidal layer, and NGS revealed an EGFR exon 19 deletion. Osimertinib was added to chemotherapy. Subsequent fundoscopic exam showed resolution of the choroidal metastasis, demonstrating a rapid and excellent response.<br /><br />The authors conclude that osimertinib-based regimens effectively control both systemic disease and choroidal metastases in EGFR exon 19 deleted NSCLC patients, potentially obviating the need for local ocular therapies. These cases support the use of osimertinib as a targeted systemic approach for intraocular metastases, improving visual outcomes and overall disease management.

Asset Subtitle

Natalie Shammas

Meta Tag

Speaker Natalie Shammas

Topic Local-Regional Non-small Cell Lung Cancer

Keywords

non-small cell lung cancer

NSCLC

EGFR exon 19 deletion

choroidal metastasis

vision loss

osimertinib

EGFR tyrosine kinase inhibitor

targeted therapy

intraocular metastases

systemic disease control