title: Continuous EGFR-TKI administration following radiotherapy for non-small cell lung cancer patients with isolated CNS failure.
abstract: BACKGROUND
  Based on previous reports, patients who experience isolated central nervous system (CNS) failure may not have systemic acquired resistance to EGFR-TKI therapy. However, because there are few articles that have reported on the clinical efficacy of continuous EGFR-TKI administration following progressive disease (PD) in isolated CNS metastasis, we retrospectively investigated the possibility of using the treatment.
  
  
  METHODS
  From July 2002 to December 2009, 17 non-small cell lung cancer patients showed isolated CNS failure after clinical benefit (partial response or stable disease longer than 6 months) from EGFR-TKIs and continuously received EGFR-TKIs following radiotherapy (whole brain radiotherapy or stereotactic radiotherapy) to the CNS metastases.
  
  
  RESULTS
  The response rate and the disease control rate of CNS lesions were 41% and 76%, respectively. The median progression free survival, extracranial progression free survival and the median overall survival time were 80 days, 171 days and 403 days, respectively. The toxicities which were observed during the first EGFR-TKI treatments were sustained, but did not worsen during this study period. The acute toxicities caused by radiotherapy to the CNS were controllable. There were no remarkable late toxicities related to the treatment.
  
  
  CONCLUSIONS
  Continuous administration of EGFR-TKI following radiotherapy after PD in isolated CNS metastasis appears to be a valid treatment option.
authors.affiliation: Division of Thoracic Oncology, Shizuoka Cancer Center, Nagaizumi-chou, Suntou-gun, Shizuoka, Japan. tshukuya@juntendo.ac.jp
authors.forename: Takehito
authors.initials: T
authors.lastname: Shukuya
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Tateaki
authors.initials: T
authors.lastname: Naito
authors.forename: Rieko
authors.initials: R
authors.lastname: Kaira
authors.forename: Akira
authors.initials: A
authors.lastname: Ono
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Asuka
authors.initials: A
authors.lastname: Tsuya
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kenmotsu
authors.forename: Haruyasu
authors.initials: H
authors.lastname: Murakami
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Harada
authors.forename: Koichi
authors.initials: K
authors.lastname: Mitsuya
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakasu
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology / Q000528:radiation effects*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology / Q000532:radiotherapy / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology / Q000532:radiotherapy / Q000556:secondary; D002493:Central Nervous System Diseases; D018450:Disease Progression; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors