Elsevier

Clinical Lung Cancer

Volume 6, Issue 2, September 2004, Pages 123-128
Clinical Lung Cancer

Brief Communication
Gefitinib in Patients with Brain Metastases from Non–Small-Cell Lung Cancer: Review of 15 Clinical Cases

https://doi.org/10.3816/CLC.2004.n.026Get rights and content

Abstract

The clinical efficacy of gefitinib, a tyrosine kinase inhibitor of epidermal growth factor receptor (EGFR), on brain metastases (BMs) from non–small-cell lung cancer (NSCLC) was evaluated. Fifteen patients with recurrent NSCLC with metastasis to the brain were treated with gefitinib. The objective tumor response rate (60%; 9 of 15 patients) for BM was the same as for primary tumors. The median time to response of BM was 26 days. In 8 of 9 patients who exhibited partial response in the thoracic lesion, BM showed dramatic regression, including 1 complete response. One patient with stable primary tumor also exhibited partial response in BM with this monotherapy. Brain metastasis–related neurologic symptoms such as hemiparesis, dysarthria, dysphagia, and vertigo improved or disappeared with the objective response of BM as confirmed by magnetic resonance imaging. Central nervous system toxicities were not observed during the treatment. Four of the 9 BM responders are still under treatment with neither adverse events nor disease progression. Two discontinued the treatment because of severe hepatic toxicity and 3 died because of acquired resistance in pulmonary lesions, even though partial response was observed in the BMs. Finally, median duration of response of BM was 8.7 months and median overall survival was 8.3 months (range, 1.8 to > 15.7 months). Molecular targeted therapy against EGFR could be an option for the treatment of BM from NSCLC refractory to conventional chemotherapy plus radiation therapy because it has demonstrated a distinct therapeutic potential against BM compared with primary lung tumor and extracranial metastases.

References (34)

  • JB Sorensen et al.

    Brain metastases in adenocarcinoma of the lung: frequency, risk groups, and prognosis

    J Clin Oncol

    (1988)
  • A Law et al.

    Emergence of increased cerebral metastasis after high-dose preoperative radiotherapy with chemotherapy in patients with locally advanced non-small cell lung carcinoma

    Cancer

    (2001)
  • M Fukuoka et al.

    Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer

    J Clin Oncol

    (2003)
  • AB Heimberger et al.

    Brain tumors in mice are susceptible to blockade of epidermal growth factor receptor (EGFR) with the oral, specific, EGFRtyrosine kinase inhibitor ZD1839 (Iressa)

    Clin Cancer Res

    (2002)
  • F Cappuzzo et al.

    ZD 1839 in patients with brain metastases from non-small-cell lung cancer (NSCLC): report of four cases

    Br J Cancer

    (2003)
  • JL Villano et al.

    A case study documenting the anticancer activity of ZD1839 (Iressa) in the brain

    Ann Oncol

    (2003)
  • P Therasse et al.

    New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada

    J Natl Cancer Inst

    (2000)
  • Cited by (0)

    Electronic forwarding or copying is a violation of US and International Copyright Laws.

    Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Cancer Information Group, ISSN #1525-7304, provided the appropriate fee is paid directly to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923 USA 978-750-8400.

    View full text