Brain Metastases from Non-Small Cell Lung Cancer: Clinical Benefits of Erlotinib and Gefitinib

M. Houman Fekrazad, Omid Sanaei, Julie E. Bauman, Dennie V. Jones

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations

Abstract

Brain metastases are seen in a considerable number of patients with non-small cell lung cancer (NSCLC) and when they occur will pose a negative impact on patients' survival. Diverse therapeutic options are being used to treat brain metastases including surgical excision, stereotactic radiosurgery, whole brain radiotherapy and systemic therapy. Of systemic therapies, gefitinib and erlotinib, epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), have shown benefit in treatment of brain metastases in patients with NSCLC. They are particularly effective in those whose lesions harbor activating EGFR mutations, as well as those selected with certain clinical features including young non-smokers, females, and those with East-Asian ethnicity or with adenocarcinoma histology. Gefitinib and erlotinib also have the advantage of exerting their antitumor activity with a favorable toxicity profile. However, they may fail after months of continuous use due to development of drug resistance. In these situations, adopting other treatment strategies such as switching drugs or dose escalation may be suitable alternatives. Several clinical trials in different phases are currently evaluating the efficacy of gefitinib or erlotinib in larger populations of NSCLC patients with brain metastases. On the other hand, new drugs such as afatinib, icotinibor crizotinib have shown benefit in patients with corresponding molecular alterations, at least in case reports or in early phase trials, and are awaiting further study in larger populations.

Original languageEnglish (US)
Title of host publicationBrain Metastases from Primary Tumors
Subtitle of host publicationEpidemiology, Biology, and Therapy
PublisherElsevier Inc.
Pages141-155
Number of pages15
ISBN (Print)9780128008966
DOIs
StatePublished - Apr 2014
Externally publishedYes

Keywords

  • Brain metastases
  • EGFR mutation
  • Epidermal growth factor receptor tyrosine kinase inhibitors
  • Erlotinib
  • Gefitinib
  • Non-small cell lung cancer

ASJC Scopus subject areas

  • Neuroscience(all)

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