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[Primary result of the efficacy and tolerance of gefitinib in advanced non-small cell lung cancer patients with brain metastasis].

BACKGROUND
Gefitinib, an orally active epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), has shown targeted antitumor activity in patients with advanced non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the efficacy and tolerance of gefitinib on brain metastasis in patients with NSCLC.


METHODS
The clinical characteristics, response to treatment and outcome of survival were retrospectively reviewed in eighteen NSCLC patients with brain metastasis. All these patients received gefitinib of 250mg/d after brain metastasis was diagnosed. They would discontinued the targeted treatment because of disease progression or other reasons. Twelve of them received intracranial irradiation (group A), while the other six patients didn't (group B).


RESULTS
The overall response rate and disease controlled rate of gefitinib for brain lesions were 27.8% and 88.9% respectively (one complete remission, 4 partial remission, 11 stable disease, 2 progressive disease). No correlation among gender, smoking status, intracranial irradiation and the response of gefitinib was observed. There was no survival difference between the two groups (P=0.192), with the median follow-up time of 6 months (range 1-24 months). Rash and diarrhea were the most common adverse events.


CONCLUSIONS
Gefitinib is active in patients with brain metastasis from NSCLC. It is feasible to conduct randomized clinical trials to demonstrate the role of targeted treatment for NSCLC patients with metastatic brain lesions.