The Continuation of Erlotinib Treatment in Non-Small Cell Lung Cancer Patients Whose Brain Lesion Is the Only Site of Progression: Prospective Pilot Study.
10.7599/hmr.2015.35.3.180
- Author:
Kwai Han YOO
1
;
Seung Tae KIM
;
Ki Sun JUNG
;
Ji Yun LEE
;
Sung Hee LIM
;
Min Young LEE
;
Hae Soo KIM
;
Hee Jin KWON
;
In Young KIM
;
Jong Mu SUN
;
Jin Seok AHN
;
Keunchil PARK
;
Myung Ju AHN
Author Information
1. Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. silk.ahn@samsung.com
- Publication Type:Original Article
- Keywords:
Carcinoma, Non-Small-Cell Lung;
Central Nervous System;
Quinazolines;
Local therapy
- MeSH:
Brain*;
Carcinoma, Non-Small-Cell Lung*;
Central Nervous System;
Disease-Free Survival;
Epidermal Growth Factor;
Humans;
Neoplasm Metastasis;
Phosphotransferases;
Pilot Projects*;
Prospective Studies*;
Quinazolines;
Radiosurgery;
Radiotherapy;
Erlotinib Hydrochloride
- From:Hanyang Medical Reviews
2015;35(3):180-185
- CountryRepublic of Korea
- Language:English
-
Abstract:
There have been conflicting reports on the continuation of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patients with newly developed or progressive brain metastasis of non-small cell lung cancer (NSCLC). Patients with newly developed or progressive intracranial lesions, but who maintained well-controlled extracranial disease during erlotinib treatment, were enrolled in this study. The proposed therapy included stereotactic radiosurgery (SRS), whole brain radiotherapy (WBRT), and/or surgical resection for intracranial lesions. Erlotinib treatment was continued simultaneously unless extracranial disease progressed. The evaluation of both extra- and intra-cranial lesions was performed every 3 months. From October 2009 to June 2012, 14 patients were enrolled in this pilot study. For intracranial disease, 4 patients received SRS alone, 7 patients received both SRS and WBRT, 2 patients received SRS, WBRT and surgical resection, and 1 patient received no local therapy due to the presence of asymptomatic lesions. Of the patients with extracranial disease who were placed on continued erlotinib therapy, 6 patients (42.9%) showed partial response (PR), while 7 patients (50.0%) remained in stable disease (SD). The progression-free survival (PFS) of extracranial and intracranial disease was 11.1 (range 1.6-34.6) and 10.2 (range 1.5-34.6) months, respectively. In 5 cases, brain lesions relapsed before the progression of extracranial disease. Overall survival (OS) was 22.6 (range 2.1-50.4) months. For NSCLC patients with progression of only intracranial disease during erlotinib treatment, the continuation of erlotinib in combination with local therapy to brain metastases can be an effective treatment option.
