Treatment > ZD1839 (Iressa)

Meeting Abstract

Non small cell lung cancer (NSCLC) metastatic to the brain: A cohort study

E. A. Diaz-Canton, G. Recondo

Instituto Universitario CEMIC, Buenos Aires, Argentina

Introduction. This is a prospective-retrospective cohort study to evaluate the clinical behaviour of patients with NSCLC metastatic to the brain, treated according to our standard policy.

Patients & Methods. We evaluated 30 patients treated by our group.
Median age was 56 (39-80).
Gender distribution: males (57%)/ females (43%).
Brain metastases were multiple in 77%.
Metachronic in 87%.
Most (60%) had metastatic disease outside of the central nervous system (CNS).
Only 23% had neurosurgery.
All patients received radiation therapy to the brain.
The majority (87%) received chemotherapy, and 2 chemo-refractory patients received gefitinib (Iressa) within the context of a compasionate protocol.
Steroids were given to the entire population and anticonvulsivants to 40%.

Results. With a median follow up of 10 months (2-92), the median survival time (MST) since the diagnosis of metastatic disease was 10 months (2-46).
MST since the diagnosis of brain metastases was 6 months (1-46).
At the time of the present analisis 20% of the patients are alive.
Response rate (RR) to the treatment was as follows: CNS-RR: 32% (5/8 CR, 3/8 PR); Extra-CNS-RR: 22% (2/6 CR, 4/6 PR), (p=0.4).
One patient achieved a CNS-CR of short duration with Gemantinib.
Quality of life was evaluated according to the mainteinance of a "Good" (0-2) or "Bad" (3-4) Zubrod Performance Status within 80% of the follow-up time:
(1) Good PS was seen in 73% of the patients, and poor in 27%. (p= 0.0015).
Causes of death were: neurologic in 18%; and non-neurologic in 82%. (p= 0.0001).

Conclusions. Our cohort of patients with NSCLC metastatic to the brain depicted:
1. Equivalent RR to the anticancer treatment/s, either the metastatic disease was located within or outside the CNS.
2. Antitumoral activity to Gemantinib as a single-agent (1 CNS-CR).
3. A short median survival time since the diagnosis of brain disease.
4. According to our simple QOL measurement, a "good" quality of life in most of the patients.
5. Majority of the patients died of extra-neurologic causes.

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