Gefitinib as palliative therapy for lung adenocarcinoma metastatic to the brain.
BACKGROUND
Lung cancer is the leading cause of cancer deaths in most countries. In patients with metastases, such as the brain, the 1-year survival is 10% and most of these patients die in 1-3 months. Data from large phase II trials of non-small cell lung cancer (NSCLC) suggested that the histologic subtype of adenocarcinoma may be a prognostic factor for patients treated with gefitinib. To evaluate the efficacy of gefitinib in palliative therapy for advanced patients with adenocarcinoma and brain metastases, we conducted a phase II study.


METHODS
Eligible patients had histologically confirmed adenocarcinoma and brain metastases confirmed with radiological studies. All eligible patients had undergone chemotherapy previously. From December 2003 to December 2004, 40 patients received 250mg doses of gefitinib daily. The symptomatic response, survival, and toxicity were recorded.


RESULTS
The overall objective response rate was 32% with a disease control rate of 77%. Altogether, 45% of the patients experienced symptom improvement. The median progression-free survival and overall survival were 9.0 months and 15.0 months, respectively. Gefitinib was well-tolerated, with cutaneous reactions as the most frequent toxicity.


CONCLUSIONS
Our data suggest that gefitinib has promising activity in palliative therapy for patients with advanced lung adenocarcinoma and brain metastasis.
Wu
Chi
C
Department of Respiratory Diseases, Peking Union Medical College Hospital, China. wchi1976@sina.com
Li
Yun Long
YL
Wang
Zhao Meng
ZM
Li
Zhang
Z
Zhang
Tong Xiao
TX
Wei
Zhong
Z
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000556:secondary*; D018572:Disease-Free Survival; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011788:Quality of Life; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis
D000970:Antineoplastic Agents; D011799:Quinazolines; D000077156:Gefitinib