This study wanted to analyse which type of medication is best in treating lung cancer that may have spread to the brain. The study found that using erlotinib (Tarceva) is better than using gefitinib (Iressa) in preventing and treating tumors in the brain that have spread from the lung.
Epidermal growth factor receptor (EGFR) is found on some types of cell. It is involved in receiving signals from the body to tell the cell to grow. It is sometimes found in high numbers on some types of cancer cells. It is possible to use this receptor to target those cancer cells and stop them from growing. Two types of medication which target EGFR are called erlotinib and gefitinib. One type of cancer which commonly has EGFR in high numbers is non-small cell lung cancers. Targeting EGFR in these kinds of cancer has been shown to work better than chemotherapy. However, it is not known if targeting EGFR works when the cancer has spread from the lung to the brain. It is also not known if targeting EGFR can prevent the spread of the cancer from the lung to the brain.
This study consisted of 77 patients. None of the patients had been treated with erlotinib or gefitinib before. They all had stage 3 or 4 lung cancer, or lung cancer that had come back. The lung cancer had mutations in the EGFR which meant it was able to be targeted by erlotinib or gefitinib. In some of the patients, the lung cancer had already spread to the brain. Of the 77 patients, 55 were treated with gefitinib and 22 were treated with erlotinib.
On average, the patients treated with erlotinib went for 11 months without their cancer progressing or spreading. The patients treated with gefitinib went for 10 months without their cancer progressing or spreading. Some of the patients who already had tumors in their brain when the study started. The patients with brain tumors who were treated with erlotinib went for 12 months without their cancer progressing or spreading. The patients with brain tumors who were treated with gefitinib went for 10 months without their cancer progressing or spreading.
The authors found that using erlotinib for treatment of lung cancer which may have spread to the brain is slightly better than using gefitinib.
This is a very small study. None of the results were found to be significant. A larger study may find more significant results.