PMID- 15474674
OWN - NLM
STAT- MEDLINE
DCOM- 20050207
LR  - 20181130
IS  - 0169-5002 (Print)
IS  - 0169-5002 (Linking)
VI  - 46
IP  - 2
DP  - 2004 Nov
TI  - Effect of gefitinib ('Iressa', ZD1839) on brain metastases in patients with 
      advanced non-small-cell lung cancer.
PG  - 255-61
AB  - BACKGROUND: Gefitinib ('Iressa', ZD1839), an orally active epidermal growth 
      factor receptor (EGFR) tyrosine kinase inhibitor (EGFR-TKI), has shown antitumor 
      activity in refractory patients with non-small-cell lung cancer (NSCLC) in 
      clinical trials. We have retrospectively analyzed the efficacy and tolerability 
      of gefitinib in patients with advanced NSCLC treated at Okayama University 
      Hospital. METHODS: We reviewed the clinical records of 57 patients with advanced 
      NSCLC who had received 250 mg/day gefitinib at our hospital between November 2000 
      and May 2003. Correlations between the sensitivity of brain metastases and 
      extracranial disease following treatment with gefitinib were also investigated. 
      RESULTS: Extracranial objective responses were observed in 15 (27%; 95% 
      confidence interval 15.8-40.3%) patients. Fourteen out of 57 patients had brain 
      metastases; six experienced objective responses (one complete response, CR and 
      five partial responses, PR) and eight had stable disease (SD) in the brain. Seven 
      out of 14 patients with brain metastases experienced objective responses in their 
      extracranial tumors and, interestingly, objective responses in the brain were 
      observed in six (86%) of these patients. Multivariate analysis found that 
      advanced age (> or = 70 years) and the presence of brain metastases were 
      associated with clinical response to gefitinib (P = 0.01 and 0.05, respectively), 
      and that female patients were more likely to respond. Median survival and median 
      duration of response were 9.1 and 7.7 months, respectively. The majority of 
      adverse events (AEs) were mild and reversible skin and gastrointestinal 
      disorders, with grade 3 adverse events observed in six (11%) patients. 
      CONCLUSIONS: This retrospective analysis has found that gefitinib is effective 
      and well tolerated in patients with refractory NSCLC, confirming previous phase 
      II trial data. Interestingly, gefitinib appeared to be effective for brain 
      metastases as well as extracranial tumors. Further prospective trials are 
      warranted to evaluate the efficacy of gefitinib in elderly patients and in 
      patients with brain metastases.
FAU - Hotta, Katsuyuki
AU  - Hotta K
AD  - Department of Hematology, Oncology and Respiratory Medicine, Graduate School of 
      Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8558, 
      Japan. khotta@md.okayama-u.ac.jp
FAU - Kiura, Katsuyuki
AU  - Kiura K
FAU - Ueoka, Hiroshi
AU  - Ueoka H
FAU - Tabata, Masahiro
AU  - Tabata M
FAU - Fujiwara, Keiichi
AU  - Fujiwara K
FAU - Kozuki, Toshiyuki
AU  - Kozuki T
FAU - Okada, Toshiaki
AU  - Okada T
FAU - Hisamoto, Akiko
AU  - Hisamoto A
FAU - Tanimoto, Mitsune
AU  - Tanimoto M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - Ireland
TA  - Lung Cancer
JT  - Lung cancer (Amsterdam, Netherlands)
JID - 8800805
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Quinazolines)
RN  - S65743JHBS (Gefitinib)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/adverse effects/*pharmacology/*therapeutic use
MH  - Brain Neoplasms/*drug therapy/*secondary
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/*secondary
MH  - Female
MH  - Gefitinib
MH  - Humans
MH  - Lung Neoplasms/*pathology
MH  - Male
MH  - Middle Aged
MH  - Quinazolines/adverse effects/*pharmacology/*therapeutic use
MH  - Retrospective Studies
MH  - Sex Factors
EDAT- 2004/10/12 09:00
MHDA- 2005/02/08 09:00
CRDT- 2004/10/12 09:00
PHST- 2003/12/30 00:00 [received]
PHST- 2004/04/15 00:00 [revised]
PHST- 2004/04/19 00:00 [accepted]
PHST- 2004/10/12 09:00 [pubmed]
PHST- 2005/02/08 09:00 [medline]
PHST- 2004/10/12 09:00 [entrez]
AID - S0169500204002144 [pii]
AID - 10.1016/j.lungcan.2004.04.036 [doi]
PST - ppublish
SO  - Lung Cancer. 2004 Nov;46(2):255-61. doi: 10.1016/j.lungcan.2004.04.036.