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Y. Nakamura



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    P2.03b - Poster Session with Presenters Present (ID 465)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.03b-019 - Comparison of the Efficacy of First-Generation EGFR-TKIs in Brain Metastasis (ID 5986)

      14:30 - 14:30  |  Author(s): Y. Nakamura

      • Abstract

      Background:
      Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are more effective in patients with advanced non-small-cell lung cancer (NSCLC) with EGFR mutations, compared with standard chemotherapy. In Japan, gefitinib, erlotinib, afatinib, and osimertinib have been approved so far. However, data comparing the efficacies of different EGFR-TKIs, especially in brain metastasis, are lacking.

      Methods:
      EGFR-TKI-naive patients with recurrent or stage IIIB/IV NSCLC with EGFR mutations, excluding resistance mutations, were enrolled in this study. We retrospectively analyzed the time to progression of brain metastasis in patients who received either gefitinib or erlotinib using the Kaplan-Meier method with the log-rank test.

      Results:
      Seventy-eight EGFR-TKI-naive patients received either gefitinib (n = 56) or erlotinib (n = 22) from April 2010 to April 2016 in our hospital. During EGFR-TKI treatment, brain metastasis progression was observed in 10 of the 56 patients (17.8%) in the gefitinib group and in 1 of the 22 patients (4.5%) in the erlotinib group. Prior to EGFR-TKI treatment, 15 patients in the gefitinib group and 12 in the erlotinib group had brain metastasis. Among these patients, brain metastasis progression was observed in 7/15 (46.7%) in the gefitinib group and 0/12 (0%) in the erlotinib group. Although event (brain metastasis progression)-free survival was marginally better in the erlotinib group, erlotinib significantly reduced brain metastasis progression in patients who had brain metastasis prior to EGFR-TKI treatment compared with gefitinib (P = 0.011, Figure). Figure 1



      Conclusion:
      Although this was a retrospective analysis involving a small sample size, erlotinib is potentially more promising than is gefitinib for brain metastasis in patients with EGFR-mutant NSCLC, especially those with brain metastasis prior to EGFR TKI treatment.