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M.B. Bychkov



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    P3.10 - Poster Session 3 - Chemotherapy (ID 210)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P3.10-037 - Drug therapy for patients with brain metastases from non-small cell lung cancer. (ID 2150)

      09:30 - 09:30  |  Author(s): M.B. Bychkov

      • Abstract

      Background
      About 30–40% of all patients (pts) with non-small cell lung cancer (NSCLC) develop brain metastases (BM), leading to a poor prognosis and a median survival of <6 months after whole brain radiotherapy. There have not been standards of drug therapy for treatment for pts with BM. The main goal of this trial is to assess the efficacy of different schemes of drug therapy in pts with BM from NSCLC.

      Methods
      87 pts were included in this study. 56 pts with NSCLC were treated with gemcitabine (Gem) - 1000 mg/m[2] intravenous on days 1 and 8 + cisplatin (Cis) – 50 mg/m[2] intravenous on days 1 and 8, every 3-4 weeks. 10 pts with NSCLC (adenocarcinoma, without epidermal growth factor receptor (EGFR) mutations) were treated with paclitaxel (Pacl) -175 mg/m[2] intravenous on day 1 + Carboplatin (Carb) – AUC=6 intravenous on day 1, every 3 weeks. 21 pts with NSCLC (adenocarcinoma, with EGFR mutations – 12 pts; adenocarcinoma, without EGFR mutations – 9 pts) received treatment with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) gefitinib (Gef) - 250mg/day (15 pts) or erlotinib (Erl) - 150 mg/day (6 pts) until radiologically-verified progressive disease. The main aims of this study were objective response (OR) – complete response (CR) + partial response (PR) in the brain and in the extracranial sites (ES), median of survival (MoS), 1-year survival.

      Results
      Observations were as follows: in the Gem + Cis treated pts, 26 OR (46,4%) in 56 pts group in the brain and 22 OR (40,0%) in 55 pts group in ES. The MoS was 9.0 months, 1-year survival was 30,3%. In the Pacl + Carb treated pts, there were 3 OR (30,0%) in 10 pts group in the brain and 4 OR (40,0%) in 10 pts group in ES. The MoS was 7,5 months, 1-year survival was 30,0%. In the EGFR TKIs treated pts (with EGFR mutations), there were 9 OR (75,0%) in 12 pts group in the brain and 7 OR (70,0%) in 10 pts group in ES. The MoS was 14,5 months, 1-year survival was 66,6%. In the EGFR TKIs treated pts (without EGFR mutations), there were no OR in 9 pts group in the brain and in ES. The MoS was 4 months, 1-year survival was 11,1%.

      Conclusion
      Previous results of our study showed that efficacy of drug therapy in patients with BM from NSCLC depends on biology of tumor and scheme of treatment. The best results achieved in pts with EGFR mutations who received EGFR TKIs (Gef or Erl). Further investigation is to be expected.