title: Erlotinib for the treatment of brain metastases in non-small cell lung cancer.
abstract: BACKGROUND
  Brain metastases (BM) are a common and lethal complication of non-small cell lung cancer (NSCLC) with up to 40% experiencing this complication. The use of erlotinib, a small molecule epidermal growth factor receptor (EGFR) inhibitor, holds promise in this somewhat refractory cohort of patients, and has become the subject of active clinical investigation.
  
  
  METHODS
  This review covers the preclinical and clinical studies of erlotonib as it relates to its use in the treatment of NSCLC patients with BM. A literature search in part utilized the PubMed database up through Dec 2015.
  
  
  CONCLUSIONS
  Preclinical and retrospective data for erlotinib provide evidence of CNS penetration, and objective responses in the setting of BM from EGFR mutated NSCLC. Phase I and II data have demonstrated the feasibility of concomitant delivery of erlotinib and WBRT in the treatment of BM from NSCLC. Phase II/III data however, from non-EGFR mutation enriched populations, have demonstrated no benefit in progression free or overall survival with the addition of erlotinib to metastasis directed radiotherapy. Currently the utilization of erlotinib with WBRT or SRS is therefore investigational and may be a reasonable option in erlotinib naïve, EGFR mutated patients with refractory BM.
authors.affiliation: a Department of Human Oncology , University of Wisconsin Carbone Cancer Center, University of Wisconsin Hospital and Clinics , Madison , WI , USA.
authors.forename: Jeffrey V
authors.initials: JV
authors.lastname: Brower
authors.affiliation: a Department of Human Oncology , University of Wisconsin Carbone Cancer Center, University of Wisconsin Hospital and Clinics , Madison , WI , USA.|b Department of Medicine , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA.|c Department of Neurology , University of Wisconsin School of Medicine and Public Health , Madison , WI , USA.
authors.forename: H Ian
authors.initials: HI
authors.lastname: Robins
mesh_terms: D000970:Antineoplastic Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D066246:ErbB Receptors / Q000235:genetics*; D000069347:Erlotinib Hydrochloride / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009154:Mutation; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: Erlotinib; brain metastases; non-small cell lung cancer; radiotherapy