EGFR mutations in patients with brain metastases from lung cancer:: Association with the efficacy of gefitinib
EGFR mutations in patients with brain metastases from lung cancer:: Association with the efficacy of gefitinib
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DOI：
10.1215/15228517-2005-002
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发表时间：
2006-04-01
期刊：
影响因子：
15.9
通讯作者：
Yoshida, J
中科院分区：
文献类型：
--
作者：
Shimato, S;Mitsudomi, T;Yoshida, J
吉非替尼是表皮生长因子受体（EGFR）相关酪氨酸激酶的特异性抑制剂，已在非小细胞肺癌（NSCLC）常规化疗患者亚组中证实有效。还报告其对NSCLC脑转移瘤具有抗肿瘤作用。此外，EGFR突变已显示与NSCLC的吉非替尼敏感性密切相关。在此，我们评估了吉非替尼治疗NSCLC脑转移的疗效，并评估了这种疗效与EGFR突变的相关性。我们回顾性分析了8例患者在开始吉非替尼治疗前患有脑转移的病例。在这些患者中，可以通过MRI评价脑肿瘤缓解;还可以进行EGFR基因分析。我们评估了吉非替尼治疗后是否观察到客观肿瘤缓解，并将吉非替尼的疗效评估为有效、无效或无法评估（考虑既往放疗的影响）。在这8名患者中，吉非替尼的疗效被评估为3名有效，3名无效。所有3例显示有效疗效的患者均在酪氨酸激酶结构域中存在EGFR突变（2例患者发生缺失突变，1例患者发生点突变），而3例显示无效疗效的患者均未发生EGFR突变。吉非替尼似乎在治疗脑转移瘤的一个亚组的患者是有效的。我们的数据表明，吉非替尼治疗脑转移瘤的疗效与EGFR突变之间可能存在相关性。
Gefitinib-a specific inhibitor of epidermal growth factor receptor (EGFR)-associated tyrosine kinase-has demonstrated efficacy in a subgroup of patients with non-small-cell lung carcinoma (NSCLC) who fall conventional chemotherapy. It is also reported to have an antitumor effect in brain metastases from NSCLC. Additionally, EGFR mutations have shown a strong association with gefitinib sensitivity for NSCLC. Here, we assessed the efficacy of gefitinib in brain metastases from NSCLC and evaluated the association of this efficacy with EGFR mutations. We retrospectively reviewed eight cases in which patients were suffering from brain metastases before the initiation of gefitinib treatment. Brain tumor response could be evaluated by MRI in these patients; EGFR gene analyses were also available. We evaluated whether objective tumor response was observed after gefitinib treatment and assessed the efficacy of gefitinib as effective, noneffective, or not assessable in consideration of the influence of previous radiotherapy. Of the eight patients, the efficacy of gefitinib was assessed as effective in three and as noneffective in three. All three patients demonstrating effective efficacy had EGFR mutations in the tyrosine kinase domain (deletion mutation in two patients and point mutation in one patients), whereas none of the three patients demonstrating noneffective efficacy had EGFR mutations. Gefitinib appears to be effective in treating brain metastases in a subgroup of patients. Our data suggested a possible association between the efficacy of gefitinib in the treatment of brain metastases and EGFR mutations.