The effectiveness of EGFR-TKIs against brain metastases in EGFR mutation-positive non-small-cell lung cancer

Abstract

Brain metastases are usual in non-small-cell lung cancer (NSCLC) with poor prognosis and few available therapeutic options. This retrospective study aims to evaluate the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) against brain metastases from NSCLC harboring activating EGFR mutation. A total of 148 patients with brain metastases from EGFR mutation-positive NSCLC were analyzed retrospectively. The patients were orally given gefitinib (250 mg) or erlotinib (150 mg) once a day until intracranial disease progression, death, or intolerable side effects. A survival analysis was done using the Kaplan-Meier analysis and log-rank test. Objective response rate and disease control rate within brain lesions were 36.5% and 87.2%, respectively, with a median progression-free survival (PFS) and overall survival (OS) of 11.2 months (95% confidence interval [CI], 10.1-12.3) and 13.6 months (95% CI, 12.3-14.9), respectively. The patients' characteristics were not statistically associated with PFS and OS. EGFR-TKIs showed promising antitumor activity against brain metastases in NSCLC patients with activating EGFR mutation and might be the treatment choice in this clinical setting.

Keywords: EGFR inhibitors; brain metastases; mutation; non-small-cell lung cancer; targeted therapy.

Figure 1

PFS of patients treated with EGFR-TKIs. Abbreviations: EGFR, epidermal growth factor receptor; TKI, tyrosine kinase inhibitor; PFS, progression-free survival.

Figure 2

OS of patients treated with EGFR-TKIs. Abbreviations: EGFR, epidermal growth factor receptor; TKI, tyrosine kinase inhibitor; OS, overall survival.