Clinical comparison of erlotinib and gefitinib in non-small cell lung cancer with brain metastases

OBJECTIVE To compare and evaluate the efficacy of erlotinib and gefitinib treatment of brain metastases from advanced non-small cell lung cancer.To observe the relationship of the brain lesions and PFS between TKI types and the EGFR mutations.METHODS A retrospective study was performed on 81 cases advanced NSCLC with EGFR mutation and newly-diagnosed brain metastases and 111 cases advanced NSCLC and EGFR mutation without brain metastases,who were treated in our hospital from January 1th,2009 to November 25 th,2012.All patients were divided into gefitinib or erlotinib treatment groups.Kaplan-Meier method was used to analyze the survival rate,the Log-rank test was used to compared the diffrence between the two groups.RESULTS For patients with newly diagnosed brain metastases,an objective response rate of 45.68%(37/81)and a disease control rate of 90.12%(73/81)were achieved,while those receiving gefitinib or erlotinib treatment had a progression-free survival(PFS)of 9.5or 9.0 months,respectively(P=0.344),and those with mutation in Exon 19 or Exon 21 of EGFR showed a PFS of 10.4or 8.6months,respectively(P=0.408).For patients without newly diagnosed brain metastasis,the PFS were 14 months for gefitinib and 15.0months for erlotinib(P=0.369),and 14.0months for Exon 19 mutation and 15.0months for Exon 21mutation(P=0.408).CONCLUSION It showed no profound significant differences in efficacy between gefitinib and erlotinib as the first line treatment for patients with brain metastases from advanced NSCLC and somatic EGFR mutations.