title: Erlotinib in patients with previously irradiated, recurrent brain metastases from non-small cell lung cancer: two case reports.
abstract: BACKGROUND
  With the current improvements in primary lung care, the long-term control of brain metastases becomes a clinical challenge. No established therapeutic approaches exist for cranial relapse after response to previous radiotherapy and systemic therapy. Tyrosine kinase inhibitors like erlotinib with its proven activity in non-small cell lung cancer may provide clinical benefits in such patients.
  
  
  METHODS
  Two case reports are presented illustrating the efficacy of erlotinib in patients with recurrent brain metastases and parallel thoracic progression.
  
  
  RESULTS
  Both patients showed lasting partial remissions in the brain and lung, and clinical symptom improvement.
  
  
  CONCLUSIONS
  The observed survival times of above 18 and 15 months, respectively, since occurrence of cranial disease manifestation in line with the achieved progression-free survival times of 9 and 6 months by the erlotinib third-line therapy are remarkable. The use of targeted therapies after wholebrain irradiation should be investigated more systematically in prospective clinical trials.
authors.affiliation: Klinik fur Pneumologie, Asklepios-Fachkliniken Munchen-Gauting, Gauting, Germany. j.pawel@asklepios.com
authors.forename: Joachim
authors.initials: J
authors.lastname: von Pawel
authors.forename: Horst
authors.initials: H
authors.lastname: Wagner
authors.forename: Thomas
authors.initials: T
authors.lastname: Duell
authors.forename: Barbara
authors.initials: B
authors.lastname: Poellinger
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000556:secondary* / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary* / Q000628:therapy*; D003131:Combined Modality Therapy; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D011799:Quinazolines / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride