1330 - Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) erlotinib and gefitinib in the treatment of patients with brain metastases...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Presenter David Naskhletashvili
Authors D.R. Naskhletashvili1, V. Gorbounova2
  • 1Neurooncology Dept., Russian N.N. Blokhin Cancer Research Center, 115478 - Moscow/RU
  • 2Dept. Of Chemotherapy, N.N.Blokhin Russian Cancer Research Center of RAMN, 115478 - Moscow/RU

Abstract

Background

About 30–40% of all patients (pts) with NSCLC develop BM, leading to a poor prognosis and a median survival of <6 months after whole brain radiotherapy. The role of systemic chemotherapy in the management of BM is controversial. This study was designed to evaluate EGFR TKIs erlotinib and gefitinib in NSCLC pts with BM.

Patients and methods

Eligible pts had confirmed NSCLC and BM (≥1 lesion of ≥10mm diameter) aged >18 years with ECOG performanse status (PS) of 0–2. 15 pts received gefitinib (250mg/day) and 6 pts received erlotinib (150 mg/day) until radiologically-verified progressive disease. The primary endpoints were objective response rate (ORR) - complete and partial response in the brain and progressive-free survival (PFS) depending on presence of EGFR mutations. Secondary endpoint was the median of survival (MoS). From June 2007 to April 2012, 21 pts were enrolled in this study. Demographics were: median age: 54 years (range 46–80 years); male/female: 7/14; PS 1/2: 17/4; previously treated/untreated: 13/8; adenocarcinoma/squamous cancer: 19/2; number of BM ≤3/ > 3 14/7; non-smoker/smoker: 13/8, with EGFR mutations/without EGFR mutations – 12/9.

Results

Median PFS was 7 months overall, ORR was 75% (9/12, 8 partial responses, 1 complete response) and the MoS was not reached in patients with EGFR mutations. Median PFS was 2 months overall, no objective responses and the MoS was 4 months in patients without EGFR mutations. Differences are statistically significent in ORR and PFS (p < 0.05).

Conclusions

EGFR TKIs showed high effectiveness and good disease control in patients with brain metastases from NSCLC with EGFR mutations.

Disclosure

All authors have declared no conflicts of interest.