Phase II Trial of Erlotinib Plus Concurrent Whole-Brain Radiation Therapy for Patients With Brain Metastases From Non–Small-Cell Lung Cancer
James W. Welsh,Ritsuko Komaki,Arya Amini,Mark F. Munsell,Wyatt Unger,Pamela K. Allen,Joe Y. Chang,Jeffrey S. Wefel,Susan L. McGovern,Linda L. Garland,Su S. Chen,Jamie Holt,Zhongxing Liao,Paul D. Brown,Erik P. Sulman,John V. Heymach,Edward S. Kim,Baldassarre Stea +17 more
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TLDR
Erlotinib was well tolerated in combination with WBRT, with a favorable objective response rate, and the higher-than-expected rate of EGFR mutations in unselected patients raises the possibility that EGFR-mutated tumors are prone to brain dissemination.Abstract:
Purpose Brain metastasis (BM) is a leading cause of death from non–small-cell lung cancer (NSCLC). Reasoning that activation of the epidermal growth factor receptor (EGFR) contributes to radiation resistance, we undertook a phase II trial of the EGFR inhibitor erlotinib with whole-brain radiation therapy (WBRT) in an attempt to extend survival time for patients with BM from NSCLC. Additional end points were radiologic response and safety. Patients and Methods Eligible patients had BM from NSCLC, regardless of EGFR status. Erlotinib was given at 150 mg orally once per day for 1 week, then concurrently with WBRT (2.5 Gy per day 5 days per week, to 35 Gy), followed by maintenance. EGFR mutation status was tested by DNA sequencing at an accredited core facility. Results Forty patients were enrolled and completed erlotinib plus WBRT (median age, 59 years; median diagnosis-specific graded prognostic assessment score, 1.5). The overall response rate was 86% (n = 36). No increase in neurotoxicity was detected, an...read more
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Journal ArticleDOI
Non–Small Cell Lung Cancer
David S. Ettinger,Wallace Akerley,Gerold Bepler,Andrew C. Chang,Richard T. Cheney,Lucian R. Chirieac,Thomas A. D'Amico,Todd L. Demmy,Steven J. Feigenberg,Robert A. Figlin,Ramaswamy Govindan,Frederic W. Grannis,Thierry Jahan,Mohammad Jahanzeb,Anne Kessinger,Ritsuko Komaki,Mark G. Kris,Corey J. Langer,Quynh-Thu Le,Renato G. Martins,Gregory A. Otterson,Jyoti D. Patel,Francisco Robert,David J. Sugarbaker,Douglas E. Wood +24 more
TL;DR: In 2010, approximately 222,520 new cases of lung or bronchial cancer will be diagnosed in the USA, and 157,300 patients are expected to die of this disease as discussed by the authors.
Journal ArticleDOI
The prevalence of EGFR mutation in patients with non-small cell lung cancer: a systematic review and meta-analysis
Yuelun Zhang,Jinqiu Yuan,Kai-Feng Wang,Xiao-Hong Fu,Xiao-Ran Han,Diane E Threapleton,Zuyao Yang,Chen Mao,Jin-Ling Tang +8 more
TL;DR: This study provides the exact prevalence of EGFR mutations in different countries and NSCLC patient subgroups and Random-effects models were used to pool EGFR mutation prevalence data.
Journal ArticleDOI
Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO).
Riccardo Soffietti,Ufuk Abacioglu,Brigitta G. Baumert,Stephanie E. Combs,Sara Kinhult,Johan M. Kros,Christine Marosi,Philippe Metellus,Alexander Radbruch,Salvador Villà Freixa,Michael Brada,Carmine M. Carapella,Matthias Preusser,Emilie Le Rhun,Roberta Rudà,Joerg C. Tonn,Damien C. Weber,Michael Weller +17 more
TL;DR: These guidelines are presented, which provide a consensus review of evidence and recommendations for diagnosis by neuroimaging and neuropathology, staging, prognostic factors, and different treatment options for patients with brain metastases from solid tumors.
Journal ArticleDOI
Treatment of Brain Metastases
Xuling Lin,Lisa M. DeAngelis +1 more
TL;DR: In this paper, the authors provide a summary of current therapy, as well as developments in the treatment of brain metastases from solid tumors, including targeted therapy, immunotherapy, and chemotherapy.
Journal ArticleDOI
Current approaches to the treatment of metastatic brain tumours
Taofeek K. Owonikoko,Jack L. Arbiser,Amelia Zelnak,Hui-Kuo G. Shu,Hyunsuk Shim,Adam M. Robin,Steven N. Kalkanis,Timothy G. Whitsett,Bodour Salhia,Nhan L. Tran,Timothy C. Ryken,Michael K. Moore,Kathleen M. Egan,Jeffrey J. Olson +13 more
TL;DR: This Review focuses on the clinically relevant molecular biology of brain metastases, and summarizes the current applications of these data to imaging, surgery, radiation therapy, cytotoxic chemotherapy and targeted therapy.
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