Erlotinib used for the treatment of advanced brain metastases from lung adenocarcinomas after arterial infusion chemotherapy: A clinical analysis

Objective To explore the clinical efficacy and the adverse effects of erlotinib,used as a 2nd-line treatment,in treating lung adenocarcinoma complicated by brain metastases after the failure of arterial infusion chemotherapy.Methods During the period from November 2008 to January 2011,a total of 20 cases with lung adenocarcinoma complicated by brain metastases received arterial infusion chemotherapy. This procedure was performed once every 4 weeks until the intracranial lesions became worse or intolerable toxicity emerged.Then erlotinib was employed as a 2nd-line treatment in all the patients.The dose of erlotinib was 150 mg/day,and the treatment was kept on till the diseases deteriorated or intolerable adverse effects occurred.The remission rate,progression free survival time,overall survival time and the adverse effects of erlotinib were evaluated.Results All the 20 patients received arterial infusion chemotherapy for at least 2 times,the median treatment times was 3 times.For the 20 cases receiving erlotinib treatment,the overall response rate(CR + PR) was 75%(15/20) and the disease control rate(CR + PR + SD) was 90%(18/20). The median progression free survival time was 9 months with the 95%CI being(7.65 - 10.35) months.The Overall median survival time was 15 months and the 95%CI was(11.48 - 18.53) months.The 6-month survival rate and one-year survival rate were 90%and 75%respectively.The most common adverse effects of erlotinib were skin rash(90%,18/20) and diarrhea(75%,15/20).Most adverse effects were of gradeⅠ-Ⅱ,and only 10%(2/20) of patients got adverse effects of≥3grade.Conclusion As a 2nd-line treatment for lung adenocarcinoma with brain metastases,erlotinib is very effective and tolerable.Therefore,erlotinib can be employed as a therapeutic option for the patients who has failed to respond to the arterial infusion chemotherapy.)