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Vol 5, No 3 (2009)
Review paper
Published online: 2009-05-15

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EGFR tyrosine kinase inhibitors in the treatment of brain metastases in non-small cell lung cancer

Renata Duchnowska
Onkol. Prak. Klin 2009;5(3):92-98.

Abstract

Brain is a frequent site of relapse in non-small cell lung cancer (NSCLC). Patients with brain metastases have bad prognosis and poor quality of life. Standard palliative methods used in brain metastases - surgery and radiotherapy allow for relieving neurological symptoms, whereas the role of chemotherapy is limited. More recently, some hope has been raised in relation to the use of targeted therapy including small-molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) - gefitinib and erlotinib. Current knowledge on this topic is based mainly on case reports and studies including small series of patients. Most of the studies included selected groups of patients, typically females and Asians. Usually TKIs were used in patients relapsing after previous platinum-based chemotherapy, with poorperformance status and neurological symptoms. Efficacy of TKIs in brain metastases is difficult to assess due to lack of uniform response criteria and potential impact of other therapies. Nevertheless, results to date suggest some activity of TKIs in selected populations of NSCLC patients with brain relapse. Of note, in sensitive patients response occurs early, and the control of neurological symptoms is relatively longlasting. The response to TKIs is likely to be dependent on specific genetic characteristics of both tumor and patient, but the knowledge on this issue is limited.

Keywords: non-small cell lung cancerbrain metastasistyrosine kinase inhibitorsgefitiniberlotinib

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