Prognosis of Patients with Brain Metastasis from Non-Small Cell Lung Cancer According to Gefitinib Administration

Abstract

AIM: Brain metastases (BMs) are associated with poor outcomes in patients with advanced non-small cell lung cancer (NSCLC). Recent reports demonstrated that gefitinib, an epidermal growth factor tyrosine kinase inhibitor (EGFR TKI), could be beneficial in a subset of NSCLC patients with BMs; however, its ability to improve the outcome of NSCLC patients with BMs is unknown. The aim of this study was to investigate the prognostic significance of gefitinib therapy in NSCLC patients with BMs. MATERIALS AND METHODS: We retrospectively analyzed 107 NSCLC patients who had synchronous BMs and received chemotherapy before or after whole brain radiotherapy. RESULTS: Fifty-eight patients received gefitinib therapy [Gefitinib (+)], while 49 patients did not [Gefitinib (-) group]. The Gefitinib (+) group had a higher proportion of female patients and patients with adenocarcinoma. The median overall survival (OS) was significantly higher in the Gefitinib (+) group (657 days, range: 79-2163) than in the Gefitinib (-) group (287 days, range: 73-1859) (P=0.0071). In multivariate analysis, good performance status (PS) and asymptomatic BMs were significant, independent factors for predicting a favorable outcome in the Gefitinib (+) group. In the Gefitinib (-) group, the maximum diameter of the largest BM was a prognostic factor, with borderline significance. CONCLUSIONS: Our results suggest that gefitinib therapy prolongs OS in NSCLC patients with synchronous BMs and that good PS and asymptomatic BMs are favorable prognostic factors in patients treated with gefitinib.