Abstract
Brain metastases (BM) are a common occurrence in patients with non-small cell lung cancer (NSCLC). Standard therapy options include whole brain radiotherapy and, in selected patients, surgery or stereotactic radiosurgery. The role of systemic treatment is controversial. There is a strong clinical rationale for the use of targeted therapies, because patients often have a poor performance status, and are not candidates for cytotoxic chemotherapy or radiotherapy, yet treatment is required to improve the extra-cranial disease.
The efficacy of epidermal growth factor receptor (EGFR) inhibitors in the treatment of patients with BM from NSCLC has been reported mainly in case reports or small retrospective case series, with only a few prospective trials. Current evidence suggests that the use of EGFR tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib should be considered in patients with asymptomatic CNS involvement, when clinical characteristics suggest a high likelihood of response; these characteristics are adenocarcinoma histology, never-smoker status, female gender and East Asian ethnicity. Upfront therapy with EGFR TKIs should be strongly considered in asymptomatic patients harboring activating EGFR mutations. In symptomatic BM, radiotherapy (RT) remains the standard treatment. Based on currently available data, treatment with concurrent RT and EGFR TKIs should be investigated in experimental trials only.
Keywords: Brain metastases, Central Nervous System, EGFR inhibitors, Non-small cell lung cancer, monoclonal antibodies, overall survival, tyrosine kinase inhibitor, whole brain radiotherapy, progression-free survival, epidermal growth factor receptor
Current Cancer Drug Targets
Title: Role of EGFR Inhibitors in the Treatment of Central Nervous System Metastases from Non-Small Cell Lung Cancer
Volume: 12 Issue: 3
Author(s): G. L. Ceresoli
Affiliation:
Keywords: Brain metastases, Central Nervous System, EGFR inhibitors, Non-small cell lung cancer, monoclonal antibodies, overall survival, tyrosine kinase inhibitor, whole brain radiotherapy, progression-free survival, epidermal growth factor receptor
Abstract: Brain metastases (BM) are a common occurrence in patients with non-small cell lung cancer (NSCLC). Standard therapy options include whole brain radiotherapy and, in selected patients, surgery or stereotactic radiosurgery. The role of systemic treatment is controversial. There is a strong clinical rationale for the use of targeted therapies, because patients often have a poor performance status, and are not candidates for cytotoxic chemotherapy or radiotherapy, yet treatment is required to improve the extra-cranial disease.
The efficacy of epidermal growth factor receptor (EGFR) inhibitors in the treatment of patients with BM from NSCLC has been reported mainly in case reports or small retrospective case series, with only a few prospective trials. Current evidence suggests that the use of EGFR tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib should be considered in patients with asymptomatic CNS involvement, when clinical characteristics suggest a high likelihood of response; these characteristics are adenocarcinoma histology, never-smoker status, female gender and East Asian ethnicity. Upfront therapy with EGFR TKIs should be strongly considered in asymptomatic patients harboring activating EGFR mutations. In symptomatic BM, radiotherapy (RT) remains the standard treatment. Based on currently available data, treatment with concurrent RT and EGFR TKIs should be investigated in experimental trials only.
Export Options
About this article
Cite this article as:
L. Ceresoli G., Role of EGFR Inhibitors in the Treatment of Central Nervous System Metastases from Non-Small Cell Lung Cancer, Current Cancer Drug Targets 2012; 12 (3) . https://dx.doi.org/10.2174/156800912799277430
DOI https://dx.doi.org/10.2174/156800912799277430 |
Print ISSN 1568-0096 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5576 |
Call for Papers in Thematic Issues
Advances in Cancer Biomarkers and Potential Drug Targets: From Diagnosis to Therapy
Cancer biomarkers play a crucial role in the diagnosis, prognosis, and treatment of cancer. They provide valuable information for cancer detection, risk assessment, treatment selection, and monitoring response to therapy. With advancements in molecular biology and high-throughput technologies, there has been an increasing interest in identifying and characterizing cancer biomarkers ...read more
Novel Therapeutic Approaches to Target Drug Resistant Tumors
With the development of disciplines such as chemical biology and molecular biology, the genes or proteins closely related to tumor occurrence and development have gradually become clear. Targeted therapies targeting these genes or proteins provide more effective methods for tumor treatment. Tumor targeted drugs generally only act on specific targets ...read more
ROLE OF IMMUNE AND GENOTOXIC RESPONSE BIOMARKERS IN TUMOR MICROENVIRONMENT IN CANCER DIAGNOSIS AND TREATMENT
Biological biomarkers have been used in medical research as an indicator of a normal or abnormal process inside the body, or of a disease. Nowadays, various researchers are in process to explore and investigate the biological markers for the early assessment of cancer. DNA Damage response (DDR) pathways and immune ...read more
Targeting the battlefield between host and tumor: basic research and clinical practice on reshaping tumor immune microenvironment
Immune system protects host against malignant tumors through effector cells and molecules. Cancer development and its response to therapy are regulated by inflammation, which either promotes or suppresses cancer progression. Chronic inflammation facilitates cancer progression and treatment resistance, whereas induction of acute inflammatory reactions often lead to anti-cancer immune responses. ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
In Silico Design of Protein Kinase Inhibitors: Successes and Failures
Anti-Cancer Agents in Medicinal Chemistry A Review of Ruthenium Complexes Activities on Breast Cancer Cells
Mini-Reviews in Medicinal Chemistry Vybrant DyeCycle Violet Stain Discriminates Two Different Subsets of CD34+ Cells
Current Stem Cell Research & Therapy Medical and Dental Implications of Down Syndrome: A Review Part 1: General and Craniofacial Characteristic
Applied Clinical Research, Clinical Trials and Regulatory Affairs Renaissance of the Biologically Active Vitamin A Derivatives: Established and Novel Directed Therapies for Cancer and Chemoprevention
Current Pharmaceutical Design Sleep Disturbances in Lung Cancer Patients
Current Respiratory Medicine Reviews Pharmacogenomics of Human Multidrug Resistance Associated Proteins
Current Pharmacogenomics and Personalized Medicine Chemokines as Therapeutic Targets in Non-Small Cell Lung Cancer: Update
Medicinal Chemistry Reviews - Online (Discontinued) <i>Ajuga</i> L.: A Systematic Review on Chemical Composition, Phytopharmacological and Biological Potential
Current Bioactive Compounds Advancements within Modern Machine Learning Methodology: Impacts and Prospects in Biomarker Discovery
Current Medicinal Chemistry Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitors from the Natural Origin: A Recent Perspective
Anti-Cancer Agents in Medicinal Chemistry Biological Evaluation of <sup>99m</sup>Tc-HYNIC-EDDA/tricine-(Ser)<sub>3</sub>-D4 Peptide for Tumor Targeting
Current Radiopharmaceuticals Targeting Histone Deacetylases in Neuroblastoma
Current Pharmaceutical Design Paclitaxel Efficacy is Increased by Parthenolide via Nuclear Factor- KappaB Pathways in In Vitro and In Vivo Human Non–Small Cell Lung Cancer Models
Current Cancer Drug Targets Role of Chromatography for Monitoring of Breast Cancer Biomarkers
Recent Patents on Biomarkers HER2 Targeted Therapies for Cancer and the Gastrointestinal Tract
Current Drug Targets Tumor Markers in Patients with Benign and Malignant Pulmonary Diseases; Competitive Evaluation of ProGRP, NSE and Cyfra 21-1
Recent Patents on Biomarkers Antibody-Drug Conjugate Targets
Current Cancer Drug Targets Tubulin-Targeting Agents in Hybrid Drugs
Current Medicinal Chemistry NAMPT in Regulated NAD Biosynthesis and its Pivotal Role in Human Metabolism
Current Medicinal Chemistry