吉非替尼治疗32例肺腺癌脑转移的临床经验

BACKGROUND AND OBJECTIVE: Brain metastasis was frequent in non-small cell lung cancer (NSCLC) patients with poor prognosis. Gefitinib was an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor which has been used in the treatment of NSCLC. Our study was to evaluate the efficacy and toxicities of gefitinib in lung adenocarcinoma patients with brain metastases. METHODS: We retrospectively reviewed clinical records of 32 lung adenocarcinoma patients with brain metastases, who had received gefitinib 250 mg Qd until disease progression or intolerable toxicities. RESULTS: The median overall survival (mOS) and median progression-free survival (mPFS) were 24.7 months and 11.2 months, respectively. Response rate (RR) and disease control rate (DCR) were 62.5% and 93.8%, respectively. The mOS and mPFS of gefitinib-naive patients were 35.6 months and 11.3 months, respectively, and RR and DCR were 75.0% and 100.0%, respectively. The mOS and mPFS of gefitinib treatment patients were 18.6 months and 6.7 months, respectively, and RR and DCR were 50.0% and 83.3%, respectively. The mOS and mPFS of patients with sensitive EGFR mutation were 24.8 months and 10.8 months, respectively, and RR and DCR were 75.0% and 100.0%, respectively. The mOS and mPFS of patients with unknown EGFR status were 35.6 months and 12.3 months, respectively, and RR and DCR were 53.3% and 86.7%, respectively. Treatment was well tolerated and no severe toxicities were observed. Common toxicities include: rash in 15 patients (46.9%), diarrhea in 7 cases (21.9%) and oral ulcer in 1 case (3.1%). CONCLUSION: Gefitinib was highly effective and well tolerated in lung adenocarcinoma patients with brain metastases, and could be recommended as a treatment choice for this population.