The Impact of Initial Gefitinib or Erlotinib versus Chemotherapy on Central Nervous System Progression in Advanced Non–Small Cell Lung Cancer with EGFR Mutations
Open accessAbstract
PURPOSE: This retrospective study was undertaken to investigate the impact of initial gefitinib or erlotinib (EGFR tyrosine kinase inhibitor, EGFR-TKI) versus chemotherapy on the risk of central nervous system (CNS) progression in advanced non-small cell lung cancer (NSCLC) with EGFR mutations. EXPERIMENTAL DESIGN: Patients with stage IV or relapsed NSCLC with a sensitizing EGFR mutation initially treated with gefitinib, erlotinib, or chemotherapy were identified. The cumulative risk of CNS progression was calculated using death as a competing risk. RESULTS: One hundred and fifty-five patients were eligible (EGFR-TKI: 101, chemotherapy: 54). Twenty-four patients (24%) in the EGFR-TKI group and 12 patients (22%) in the chemotherapy group had brain metastases at the time of diagnosis of advanced NSCLC (P = 1.000); 32 of the 36 received CNS therapy before initiating systemic treatment. Thirty-three patients (33%) in the EGFR-TKI group and 26 patients (48%) in the chemotherapy group developed CNS progression after a median follow-up of 25 months. The 6-, 12-, and 24-month cumulative risk of CNS progression was 1%, 6%, and 21% in the EGFR-TKI group compared with corresponding rates of 7%, 19%, and 32% in the chemotherapy group (P = 0.026). The HR of CNS progression for upfront EGFR-TKI versus chemotherapy was 0.56 [95% confidence interval (CI), 0.34-0.94]. CONCLUSIONS: Our data show lower rates of CNS progression in EGFR-mutant advanced NSCLC patients initially treated with an EGFR-TKI compared with upfront chemotherapy. If validated, our results suggest that gefitinib and erlotinib may have a role in the chemoprevention of CNS metastases from NSCLC.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
EGFR TKIs provide superior control of central nervous system disease.
“EGFR TKIs do have superior CNS disease control (discussed in a later section on management of CNS disease).58”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
The citation lists haven’t been fetched yet
References 39 · Cited by 176
- Authors
- Heon, S., Yeap, B. Y., Lindeman, N. I., Joshi, V. A., Butaney, M., Britt, G. J., Costa, D. B., Rabin, M. S., Jackman, D. M., & Johnson, B. E.
- Affiliations
- Authors' Affiliations: 1Lowe Center for Thoracic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute; 2Departments of Medicine, Harvard Medical School and 3Brigham and Women's Hospital; 4Department of Medicine, Massachusetts General Hospital; 5Departments of Pathology, Harvard Medical School, 6Brigham and Women's Hospital, and 7Massachusetts General Hospital; 8Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
- Brigham and Women's Hospital (US)
- Corresponding author
- Johnson, Bruce E.
- Venue
- Clinical Cancer Research
- Published
- 2012-08-14
- Volume
- 18
- Issue
- 16
- Pages
- 4406-4414
- ISSN
- 1078-0432 (ISSN-L)
- 1557-3265
- PMC
- PMC3682221
- OpenAlex
- W2155894313
- Cited by
- 176
- References
- 39
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 7 · 2022: 14 · 2021: 7 · 2020: 14 · 2019: 16 · 2018: 17 · 2017: 18 · 2016: 26 · 2015: 17 · 2014: 11 · 2013: 13 · 2012: 5
- FWCI
- 11.87
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Clinical Cancer Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (R01CA114465, P50CA090578, 5R01-CA114465)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Brain Metastases and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- gefitinib, erlotinib, EGFR tyrosine kinase inhibitors, EGFR mutation, non-small cell lung cancer, central nervous system progression, brain metastases, chemotherapy, upfront treatment, chemoprevention, competing risk analysis
- MeSH terms
- Erlotinib Hydrochloride, Gefitinib, Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Carcinoma, Non-Small-Cell Lung, Female, Humans, Lung Neoplasms, Male, Middle Aged, Mutation, Neoplasm Staging, Quinazolines, Recurrence, Risk Factors, Central Nervous System Neoplasms, Disease Progression, Protein Kinase Inhibitors, ErbB Receptors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
