Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 24, No 18S (June 20 Supplement), 2006: 17149
© 2006 American Society of Clinical Oncology

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Abstract

Efficacy of erlotinib in the treatment of patients with brain metastasis from non small cell lung cancer

Lebanese Oncology Group, Middle East Intitute Of Health, Bsalim, Beirut, Lebanon

17149

Background: Erlotinib has shown good activity in lung cancer.Brain metastases remain a major problem in lung cancer treatment because of the blood brain barrier.We report three cases of adenocarcinoma of the lung metastatic to the brain treated with erlotinib100 mg daily. Methods: Two males (age 54 and 57 years) and one female (age 50 years). The two male patients received combination chemotherapy for stage IV disease (carboplatine, gemcitabine, docetaxel) and recurred after initial response. Both have been irradiated to brain with relapse. The female patient received adjuvant chemotherapy (carboplatine and gemcitabine) and adjuvant radiation to the mediastinum and presented one month after the end of radiation with right upper limb paralysis and clonic crisis. Results: The three patients presented very rapid response to erlotinib, with almost disappearance of neurological signs within the first two weeks. MRI of the brain showed partial response after 15 days in two patients and after one month in the third. The female patient is still responding and well doing after four months on erlotinib without radiation nor corticosteroids or antiepileptics, the later treatments being refused by the patient. One male patient died from pulmonary embolism 40 days after the initiation of erlotinib while he was still presenting tumor response. The other two patients are still alive with partial response and no neurological symptoms, four months after the initiation of erlotinib. Conclusions: We believe that erlotinib deserves further evaluation in non small cell lung cancer metastatic to the brain. The very quick response to treatment can select responders very early because of the cost of the drug.

No significant financial relationships to disclose.