Abstract:

Objective To evaluate clinical efficacy and prognosis of gefitinib and erlotinib against brain metastases of non-small cell lung cancer（NSCLC）and to compare the difference between two drugs. Methods A total of 67 brain metastases patients of pulmonary adenocarcinoma harboring activating EGFR mutation were reviewed retrospectively. All of them were treated with oral either gefitinib（250 mg/day, n=38）or erlotinib（150 mg/day, n=29）. These patients discontinued administration of gefitinib or erlotinib when intracranial disease progression， death or intolerable side effects appeared. RECIST 1.1 was applied in response analysis. Survival analysis was compared with Kaplan-Meier method and Log-rank test respectively. Results In terms of intracranial diseases， response rate（RR）and disease control rate（DCR）were 44.8％ and 92.5％， respectively. Furthermore， RR and DCR were 42.1％， 92.1％ and 48.3％，93.1％ in gefitinib and erlotinib group， respectively（P=0.881）. As for extracranial diseases， RR and DCR were 53.7％ and 95.5％， respectively. In addition， RR and DCR were 52.6％， 94.7％ and 55.2％， 96.6％ in gefitinib and erlotinib group， respectively（P=0.932）. The median progression free survival（PFS）and overall survival time（OS）was 10.8 months and 15.3 months， respectively. Furthermore， median PFS and OS was 10.6 months， 14.8 months and 11.7 months， 15.7 months in gefitinib and erlotinib group， respectively（P=0.720， P=0.569）.
Conclusion Gefitinib and erlotinib showed promising antitumor activity against brain metastases in NSCLC patients harboring activating EGFR mutation and appear to be the treatment of choice in this clinical setting. Gefitinib and erlotinib seem to show no difference in efficacy and prognosis of these patients.