The Impact of Initial Gefitinib or Erlotinib versus Chemotherapy on Central Nervous System Progression in Advanced Non–Small Cell Lung Cancer with EGFR Mutations

摘要: Purpose: This retrospective study was undertaken to investigate the impact of initial gefitinib or erlotinib (EGFR tyrosine kinase inhibitor, EGFR-TKI) versus chemotherapy on risk central nervous system (CNS) progression in advanced non-small cell lung cancer (NSCLC) with EGFR mutations. Experimental Design: Patients stage IV relapsed NSCLC a sensitizing mutation initially treated gefitinib, were identified. The cumulative CNS calculated using death as competing risk. Results: One hundred and fifty-five patients eligible (EGFR-TKI: 101, chemotherapy: 54). Twenty-four (24%) EGFR-TKI group 12 (22%) had brain metastases at time diagnosis (P=1.000); 32 36 received therapy before initiating systemic treatment. Thirty-three (33%) 26 (48%) developed after median follow-up 25 months. 6-, 12-, 24-month 1%, 6%, 21% compared corresponding rates 7%, 19%, 32% (P=0.026). hazard ratio for upfront 0.56 (95% confidence interval, 0.34 0.94). Conclusions: Our data demonstrate lower mutant an chemotherapy. If validated, our results suggest that may have role chemoprevention from NSCLC.