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Frequent central nervous system failure after clinical benefit with epidermal growth factor receptor tyrosine kinase inhibitors in Korean patients with nonsmall-cell lung cancer.

Authors
 Young Joo Lee  ;  Hye Jin Choi  ;  Se Kyu Kim  ;  Joon Chang  ;  Jin Wook Moon  ;  In Kyu Park  ;  Joo-Hang Kim  ;  Byoung Chul Cho 
Citation
 CANCER, Vol.116(5) : 1336-1343, 2010 
Journal Title
 CANCER 
ISSN
 0008-543X 
Issue Date
2010
MeSH
Aged ; Antineoplastic Agents/therapeutic use* ; Asian Continental Ancestry Group* ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Central Nervous System Neoplasms/secondary* ; Disease Progression ; Erlotinib Hydrochloride ; Female ; Humans ; Incidence ; Korea ; Male ; Protein Kinase Inhibitors/therapeutic use* ; Quinazolines/therapeutic use ; Receptor, Epidermal Growth Factor/antagonists & inhibitors*
Keywords
nonsmall cell lung cancer ; epidermal growth factor receptor ; central nervous system ; recurrence ; brain‐blood‐barrier
Abstract
BACKGROUND: We investigated the risk of central nervous system (CNS) failure after clinical benefit with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in Korean patients with nonsmall-cell lung cancer (NSCLC) METHODS: We retrospectively evaluated the pattern of disease progression of 287 advanced NSCLC patients who were treated with gefitinib or erlotinib. Patients whose best tumor response was complete response, partial response, or stable disease (> or =90 days) were classified into the group receiving clinical benefit with these drugs. RESULTS: The clinical benefit group had a higher incidence of CNS failure as an initial progression, compared with the non-clinical benefit group (26% vs 4%; P < .001). Isolated CNS failure was also more frequent in the clinical benefit group than in the non-clinical benefit group (13% vs 1%; P < .001). In a multivariate analysis, clinical benefit with EGFR-TKIs significantly increased the risk of isolated CNS failure, with an adjusted hazard ratio of 10.9 (95% confidence interval [CI], 1.4-29.1, P = .01). In patients with isolated CNS failure, the median time from initial intracranial failure to extracranial failure was 9.9 months (95% CI, 1.9-21.9 months) and to death was 12.9 months (95% CI, 3.3-22.5 months). CONCLUSIONS: The CNS was frequently the initial failure site after clinical benefit with EGFR-TKIs in Korean NSCLC patients. Patients with isolated CNS failure showed durable extracranial control after cranial progression. A role for close surveillance of the CNS during EGFR-TKI treatment or prophylactic measures appears worthy of further study in these patients.
Files in This Item:
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DOI
10.1002/cncr.24877
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Kyu(김세규)
Kim, Joo Hang(김주항)
Moon, Jin Wook(문진욱)
Park, In Kyu(박인규)
Lee, Young Joo(이영주)
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100410
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