Gefitinib (Iressa) in the treatment of brain metastases from non-small cell lung carcinoma
Since 2006, the N.N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences, has been conducting an investigation of the efficiency of targeted therapy with gefitinib in patients with brain metastasis from non-small cell lung carcinoma (NSCLC). The evaluation of treatment efficiency in 9 patients with tumor EGFR mutation in NSCLC revealed that 1 (11.1 %) and 5 (55.6 %) patients achieved complete and partial regression, respectively; disease stabilization was observed in 3 (33.3 %). The median time to progression was 7 months; the patients did not achieve the median survival. The evaluation of treatment efficiency in a group of 6 patients without tumor EGFR mutation or its evidence showed complete and partial tumor regressions; disease stabilization was noted in 3 (50.0 %); disease progression was in 3 (50 %). The median time to progression was 2 months; the median survival was 5 months. Thus, the high efficiency of treatment with the EGFR inhibitor gefitinib in patients with brain metastases from NSCLS was achieved only in a group of patients with found ECFR mutations in exons 18-21 in the tumor. Determination of the status of ECFR in the tumor is the most important prognostic factor when using therapy with the EGFR tyrosine kinase inhibitor gefitinib in patients with brain metastases. The investigation is being continued.