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- Title
Twice weekly pulse and daily continuous-dose erlotinib as initial treatment for patients with epidermal growth factor receptor-mutant lung cancers and brain metastases.
- Authors
Arbour, Kathryn C.; Kris, Mark G.; Riely, Gregory J.; Ni, Ai; Beal, Kathryn; Daras, Mariza; Hayes, Sara A.; Young, Robert J.; Rodriguez, Christopher R.; Ahn, Linda; Pao, William; Yu, Helena A.
- Abstract
<bold>Background: </bold>In a phase 1 study of pulse/continuous-dose erlotinib, no patient had disease progression in the central nervous system (CNS). This expansion cohort of the phase 1 study tested the same regimen in a cohort of individuals with epidermal growth factor receptor (EGFR)-mutant lung cancers with untreated brain metastases.<bold>Methods: </bold>Patients had not received EGFR tyrosine kinase inhibitors or radiation for brain metastases. All received 1200 mg of erlotinib on days 1 and 2 and 50 mg on days 3 to 7 weekly. The primary endpoints were the overall and CNS response rates (according to version 1.1 of the Response Evaluation Criteria in Solid Tumors).<bold>Results: </bold>Between May 2015 and August 2016, 19 patients were enrolled. Forty-two percent of the patients had target brain lesions, and the median size of the target brain lesions was 13 mm. Overall, 14 patients (74%; 95% confidence interval [CI], 51%-89%) had partial responses. The response rate in brain metastases was 75%. The overall median progression-free survival was 10 months (95% CI, 7 months to not reached). Only 3 patients (16%) had CNS progression. To date, 4 patients required CNS radiation at some time during their course. The adverse events (any grade) seen in 10% or more of the patients were rash, diarrhea, nausea, an increase in alanine aminotransferase, and fatigue.<bold>Conclusions: </bold>Pulse/continuous-dose erlotinib produced a 74% overall response rate and a 75% response rate in brain metastases in patients with EGFR-mutant lung cancers and untreated brain metastases. CNS control persisted even after progression elsewhere. Although this regimen did not improve progression-free survival or delay the emergence of EGFR T790M, it prevented progression in the brain and could be useful in situations in which CNS control is critical. Cancer 2018;124:105-9. © 2017 American Cancer Society.
- Subjects
ERLOTINIB; DISEASE progression; EPIDERMAL growth factor receptors; LUNG cancer; BRAIN metastasis; ADENOCARCINOMA; ANTHROPOMETRY; BRAIN tumors; EPIDERMAL growth factor; LUNG tumors; GENETIC mutation; PROGNOSIS; RADIOTHERAPY; RESEARCH funding; TREATMENT effectiveness; PROTEIN kinase inhibitors
- Publication
Cancer (0008543X), 2018, Vol 124, Issue 1, p105
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.30990