Brain metastases from lung cancer responding to erlotinib: the importance of EGFR mutation
Open accessAbstract
Median survival of patients with brain metastases from nonsmall cell lung cancer (NSCLC) is poor and more effective treatments are urgently needed. We have evaluated the efficacy of erlotinib in this setting and its association with activating mutations in the epidermal growth factor receptor (EGFR) gene. We retrospectively identified patients with NSCLC and brain metastases treated with erlotinib. EGFR mutations in exons 19 and 21 were analysed by direct sequencing. Efficacy and tolerability were compared according to EGFR mutational status. 69 NSCLC patients with brain metastases were identified, 17 of whom harboured EGFR mutations. Objective response rate in patients with EGFR mutations was 82.4%; no responses were observed in unselected patients (p<0.001). Median (95% CI) time to progression within the brain for patients harbouring EGFR mutations was 11.7 (7.9-15.5) months, compared to 5.8 (5.2-6.4) months for control patients whose EGFR mutational status had not been assessed (p<0.05). Overall survival was 12.9 (6.2-19.7) months and 3.1 (2.5-3.9) months (p<0.001), respectively. The toxicity of erlotinib was as expected and no differences between cohorts were observed. Erlotinib is active in brain metastases from NSCLC; this clinical benefit is related to the presence of activating mutations in exons 19 or 21 of the EGFR gene.
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T790M cell populations have been reported in a proportion of TKI-naïve EGFRm+ tumors, with prevalence depending on assay.
“The existence of cell populations harboring T790M within a proportion of TKI-naïve EGFRm+ tumors has been reported, although the prevalence depends on the diagnostic assay being used.”
From AZD9291, an Irreversible EGFR TKI, Overcomes T790M-Mediated Resistance to EGFR Inhibitors in Lung Cancer (2014) · cites this paper as [57]
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- Authors
- Porta, R., Sánchez-Torres, J. M., Paz-Ares, L., Massutí, B., Reguart, N., Mayo, C., Lianes, P., Queralt, C., Guillem, V., Salinas, P., Catot, S., Isla, D., Pradas, A., Gúrpide, A., de Castro, J., Polo, E., Puig, T., Tarón, M., Colomer, R., & Rosell, R.
- Affiliations
- Institut Català d'Oncologia (ES)
- Corresponding author
- Colomer, R.
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2010-07-01
- Volume
- 37
- Issue
- 3
- Pages
- 624-631
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2124729820
- Cited by
- 316
- References
- 30
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 9 · 2021: 13 · 2020: 24 · 2019: 24 · 2018: 34 · 2017: 35 · 2016: 35 · 2015: 24 · 2014: 38 · 2013: 37 · 2012: 21
- FWCI
- 17.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- China Scholarship Council
- Universitat de Barcelona
- Universitat Autònoma de Barcelona
- University of Texas MD Anderson Cancer Center
- 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 › Oncology › HER2/EGFR in Cancer Research
- Keywords
- brain metastases, non-small cell lung cancer, erlotinib, EGFR mutation, epidermal growth factor receptor, exon 19 deletion, exon 21 mutation, targeted therapy, treatment response, time to progression, overall survival, drug toxicity
- MeSH terms
- Erlotinib Hydrochloride, Adult, Aged, Aged, 80 and over, Biopsy, Brain Neoplasms, Carcinoma, Non-Small-Cell Lung, Exons, Female, Humans, Lung Neoplasms, Male, Middle Aged, Mutation, Neoplasm Metastasis, Quinazolines, Retrospective Studies, Cohort Studies, Treatment Outcome, Protein Kinase Inhibitors, ErbB Receptors
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