Erlotinib versus gefitinib for brain metastases in Asian patients with exon 19 EGFR-mutant lung adenocarcinoma: a retrospective, multicenter study

• Published in: BMC pulmonary medicine Vol. 18; no. 1; p. 171
• Main Authors: Jiang, Ye, Zhang, Jing, Huang, Juanjuan, Xu, Bo, Li, Ning, Cao, Lei, Zhao, Mingdong
• Format: Journal Article
• Language: English
• Published: England BioMed Central 20.11.2018; BMC
• Subjects: Adenocarcinoma of Lung - drug therapy; Adenocarcinoma of Lung - genetics; Adenocarcinoma of Lung - mortality; Adenocarcinoma of Lung - pathology; Adult; Aged; Asian Continental Ancestry Group - genetics; Brain Neoplasms - drug therapy; Brain Neoplasms - secondary; China - epidemiology; ErbB Receptors - genetics; Erlotinib; Erlotinib Hydrochloride - therapeutic use; Exons; Female; Gefitinib; Gefitinib - therapeutic use; Humans; Lung adenocarcinoma; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Male; Middle Aged; Mutation; Overall survival; Protein Kinase Inhibitors - therapeutic use; Retrospective Studies; Survival Analysis; China; Lung adenocarcinoma; Erlotinib; Gefitinib; Overall survival
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-018-0734-1

The purpose of this study was to compare clinical outcomes of Erlotinib versus Gefitinib in the treatment of Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases. Consecutive Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases were identified and initially received peroral administration of 150 mg/d erlotinib or 250 mg/d gefitinib during 2009-2015. Overall survival (OS) was the primary endpoint. Progression-free survival (PFS) was the second endpoint. The cohort consisted of 227 Asian patients (erlotinib-treated cohort: n = 112, mean age = 58.5 years [SD: 20.13]; gefitinib-treated cohort: n = 115, mean age = 58.4 years [SD: 19.52]). In a multivariate analysis controlling for age, sex and time span of smoking history, significant difference was detected in the 36-month OS between erlotinib and gefitinib groups (58.3% vs. 49.1%, p = 0.012). There was also significant difference in the 36-month PFS between erlotinib and gefitinib groups (64% vs. 53%, p = 0.013). For Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and brain metastases, erlotinib was associated with a significantly longer OS and a more prolonged PFS and compared with gefitinib.