scholarly journals B1-07: Decreased neurocognitive progression with Motexafin Gadolinium (MGd) plus Whole Brain Radiation Therapy (WBRT) in non-small cell lung cancer (NSCLC) patients with brain metastases: pooled analysis of two randomized phase 3 trials

2007 ◽  
Vol 2 (8) ◽  
pp. S335-S336
Author(s):  
Minesh Mehta ◽  
Mark Leibenhaut ◽  
John Suh ◽  
Christine Meyers ◽  
Markus F. Renschler ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Pooled Analysis ◽  
Small Cell ◽  
Small Cell Lung ◽  
Phase 3 ◽  
Motexafin Gadolinium ◽  
Whole Brain Radiation ◽  
Nsclc Patients ◽  
Brain Radiation

scholarly journals The Current Role of Whole Brain Radiation Therapy in Non–Small Cell Lung Cancer Patients

2017 ◽  
Vol 12 (10) ◽  
pp. 1467-1477 ◽  
Author(s):  
Gokoulakrichenane Loganadane ◽  
Lizza Hendriks ◽  
Cécile Le Péchoux ◽  
Antonin Levy
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Small Cell ◽  
Small Cell Lung ◽  
Current Role ◽  
Lung Cancer Patients ◽  
Whole Brain Radiation ◽  
Brain Radiation

Motexafin gadolinium (MGd) combined with whole brain radiation therapy prolongs time to neurologic progression in non- small cell lung cancer (NSCLC) patients with brain metastases: Pooled analysis of two randomized phase III trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 2010-2010
Author(s):  
W. R. Shapiro ◽  
M. P. Mehta ◽  
C. Langer ◽  
A. Bezjak ◽  
R. Timmerman ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Metastases ◽  
Pooled Analysis ◽  
Whole Brain Radiation Therapy ◽  
Phase Iii ◽  
Whole Brain ◽  
Motexafin Gadolinium ◽  
Whole Brain Radiation ◽  
Nsclc Patients ◽  
Brain Radiation

2010 Background: In 2 randomized trials, whole brain radiation therapy (RT) plus MGd prolonged time to neurologic progression (TNP) in NSCLC patients (pts) with brain metastases (BM). In this report, results of a pooled analysis from both trials are presented. Methods: In trial 9801, 401 pts with BM from solid tumors were randomized to RT (30 Gy) or RT+MGd, 5 mg/kg qd x 10 days. The subgroup of 251 pts with NSCLC is included in this analysis. In trial 0211, 554 pts with BM from NSCLC were randomized to the same treatments. In both trials, eligibility included a KPS = 70, no liver metastases, and = 1 site of extracranial metastasis. In both trials, a primary endpoint was time to neurologic progression determined by a blinded events review committee (ERC), incorporating data from neurologic exams, neurologic symptom collection, and neurocognitive tests. Results: 805 pts received RT (N=403) or RT+MGd (N=402). Most pts had multiple BM (80%), extracranial metastases (47%) and presented with neurologic deficits (84%). Treatment with MGd was well tolerated, with 93.3% of intended doses administered. Most common MGd-related grade 3+ adverse events were hypertension (4.6%), and fatigue (2.8%). TNP in the RT+MGd group was 15.4 mo, significantly longer than the 9.0 mo for the RT alone group, p=0.016, HR=0.74 (95% CI 0.57–0.95). The results of both studies are consistent, as shown in the table below. Similar results were observed in time to investigator-determined neurologic progression (p=0.015, HR=0.76) and time to neurocognitive progression (memory: HR=0.80, p=0.047, executive function: HR=0.74, p=0.028, all tests combined: HR=0.78, p=0.020). Conclusions: Motexafin gadolinium significantly prolonged time to neurologic progression and neurocognitive progression in NSCLC patients with brain metastases undergoing whole brain radiation therapy in a pooled analysis of 2 randomized phase III trials. [Table: see text] No significant financial relationships to disclose.

scholarly journals Phase II Trial of Erlotinib Plus Concurrent Whole-Brain Radiation Therapy for Patients With Brain Metastases From Non–Small-Cell Lung Cancer

2013 ◽  
Vol 31 (7) ◽  
pp. 895-902 ◽  
Author(s):  
James W. Welsh ◽  
Ritsuko Komaki ◽  
Arya Amini ◽  
Mark F. Munsell ◽  
Wyatt Unger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Survival Time ◽  
Response Rate ◽  
Phase Ii Trial ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Cell Lung ◽  
Whole Brain Radiation ◽  
Brain Radiation

Purpose Brain metastasis (BM) is a leading cause of death from non–small-cell lung cancer (NSCLC). Reasoning that activation of the epidermal growth factor receptor (EGFR) contributes to radiation resistance, we undertook a phase II trial of the EGFR inhibitor erlotinib with whole-brain radiation therapy (WBRT) in an attempt to extend survival time for patients with BM from NSCLC. Additional end points were radiologic response and safety. Patients and Methods Eligible patients had BM from NSCLC, regardless of EGFR status. Erlotinib was given at 150 mg orally once per day for 1 week, then concurrently with WBRT (2.5 Gy per day 5 days per week, to 35 Gy), followed by maintenance. EGFR mutation status was tested by DNA sequencing at an accredited core facility. Results Forty patients were enrolled and completed erlotinib plus WBRT (median age, 59 years; median diagnosis-specific graded prognostic assessment score, 1.5). The overall response rate was 86% (n = 36). No increase in neurotoxicity was detected, and no patient experienced grade ≥ 4 toxicity, but three patients required dose reduction for grade 3 rash. At a median follow-up of 28.5 months (for living patients), median survival time was 11.8 months (95% CI, 7.4 to 19.1 months). Of 17 patients with known EGFR status, median survival time was 9.3 months for those with wild-type EGFR and 19.1 months for those with EGFR mutations. Conclusion Erlotinib was well tolerated in combination with WBRT, with a favorable objective response rate. The higher-than-expected rate of EGFR mutations in these unselected patients raises the possibility that EGFR-mutated tumors are prone to brain dissemination.

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