Rates of CNS progression in patients with advanced NSCLC harboring somatic EGFR mutations and treated with gefitinib or erlotinib.

Abstract

7543 Background: Gefitinib and erlotinib can penetrate into the CNS and elicit intracranial responses. However, there is incomplete data about their impact on the development and control of CNS metastases. The experience at DFCI was reviewed to determine the risk of CNS progression in patients with somatic EGFR mutations and advanced NSCLC treated initially with gefitinib or erlotinib. Methods: We identified patients with stage IIIB or IV NSCLC with somatic EGFR mutations treated with gefitinib or erlotinib as their initial therapy for advanced NSCLC between 1/01 and 2/09. The cumulative risk of brain relapse was calculated using death as a competing risk. Results: Of the 100 eligible patients, 19 had brain metastases (BM) at the time of diagnosis of advanced NSCLC; 17 of them received CNS therapy before initiating gefitinib or erlotinib. To date, 83 patients have progressed after a median potential follow-up of 41.3 months. The median progression-free survival for the entire cohort was 13.2 months. 28 pa...