scholarly journals Upfront whole brain radiotherapy for multiple brain metastases in patients with EGFR-mutant lung adenocarcinoma

2019 ◽  
Vol Volume 11 ◽  
pp. 3433-3443 ◽  
Author(s):  
Changhui Li ◽  
Jindong Guo ◽  
Lei Zhao ◽  
Fang Hu ◽  
Wei Nie ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Lung Adenocarcinoma ◽  
Whole Brain Radiotherapy ◽  
Whole Brain ◽  
Multiple Brain Metastases ◽  
Brain Radiotherapy ◽  
Egfr Mutant

scholarly journals Whole Brain Radiotherapy With and Without Concurrent Erlotinib in NSCLC with Brain Metastases: a multicentre, open-label, randomized, controlled phase 3 Trial

2020 ◽  
Author(s):  
Zhenzhou Yang ◽  
Yan Zhang ◽  
Rongqing Li ◽  
Abulimiti Yisikandaer ◽  
Biyong Ren ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Objective Response ◽  
Whole Brain Radiotherapy ◽  
Combination Group ◽  
Open Label ◽  
Phase 3 ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Egfr Mutant ◽  
Nsclc Patients

Abstract Background Erlotinib combined with whole brain radiotherapy (WBRT) demonstrated a favorable objective response rate in a phase 2 single-arm trial of non-small cell lung cancer (NSCLC) patients with brain metastases. We assessed whether concurrent erlotinib with WBRT is safe and benefits patients in a phase 3, randomized trial. Methods NSCLC patients with two or more brain metastases were enrolled and randomly assigned (1:1) to WBRT (n=115) or WBRT combined with erlotinib arms (n=109). The primary endpoint was intracranial progression-free survival (iPFS) and cognitive function (CF) was assessed by Mini–Mental State Examination (MMSE). Results A total of 224 patients from 10 centers across China were randomized to treatments. Median follow-up was 11.2 months. Median iPFS for WBRT concurrent erlotinib was 11.2 months versus 9.2 months for WBRT-alone (p=0.601). Median PFS and overall survival (OS) of combination group were 5.3 versus 4.0 months (p=0.825) and 12.9 versus 10.0 months (p=0.545), respectively, compared with WBRT-alone. In EGFR-mutant patients, iPFS (14.6 versus 12.8 months; p=0.164), PFS (8.8 versus 6.4 months; p=0.702) and OS (17.5 versus 16.9 months; p=0.221) were not significantly improved in combination group over WBRT-alone. Moreover, there were no significant differences in patients experiencing MMSE score change between the treatments. Conclusion Concurrent erlotinib with WBRT didn’t improve iPFS and excessive CF detriment either in the intent-to-treat (ITT) population or in EGFR-mutant patients compared with WBRT-alone, suggesting that while safe for patients already taking the drug, there is no justification for adding concurrent EGFR-TKI with WBRT for the treatment of brain metastases.

scholarly journals Randomized Trial of Erlotinib Plus Whole-Brain Radiotherapy for NSCLC Patients With Multiple Brain Metastases

2014 ◽  
Vol 106 (7) ◽  
Author(s):  
Siow Ming Lee ◽  
Conrad R. Lewanski ◽  
Nicholas Counsell ◽  
Christian Ottensmeier ◽  
Andrew Bates ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Randomized Trial ◽  
Whole Brain Radiotherapy ◽  
Whole Brain ◽  
Multiple Brain Metastases ◽  
Brain Radiotherapy ◽  
Nsclc Patients
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