Gefitinib--a specific inhibitor of
epidermal growth factor receptor (EGFR)-associated
tyrosine kinase--has demonstrated efficacy in a subgroup of patients with
non-small-cell lung carcinoma (NSCLC) who fail conventional
chemotherapy. It is also reported to have an antitumor effect in
brain metastases from NSCLC. Additionally, EGFR mutations have shown a strong association with
gefitinib sensitivity for NSCLC. Here, we assessed the efficacy of
gefitinib in
brain metastases from NSCLC and evaluated the association of this efficacy with EGFR mutations. We retrospectively reviewed eight cases in which patients were suffering from
brain metastases before the initiation of
gefitinib treatment.
Brain tumor response could be evaluated by MRI in these patients; EGFR gene analyses were also available. We evaluated whether objective
tumor response was observed after
gefitinib treatment and assessed the efficacy of
gefitinib as effective, noneffective, or not assessable in consideration of the influence of previous
radiotherapy. Of the eight patients, the efficacy of
gefitinib was assessed as effective in three and as noneffective in three. All three patients demonstrating effective efficacy had EGFR mutations in the
tyrosine kinase domain (deletion mutation in two patients and point mutation in one patients), whereas none of the three patients demonstrating noneffective efficacy had EGFR mutations.
Gefitinib appears to be effective in treating
brain metastases in a subgroup of patients. Our data suggested a possible association between the efficacy of
gefitinib in the treatment of
brain metastases and EGFR mutations.