Erlotinib in patients with previously irradiated, recurrent brain metastases from non-small cell lung cancer: Two case reports

Background: With the current improvements in primary lung care, the
long-term control of brain metastases becomes a clinical challenge.
No established therapeutic approaches exist for cranial relapse
after response to previous radiotherapy and systemic therapy.
Tyrosine kinase inhibitors like erlotinib with its proven activity
in non-small cell lung cancer may provide clinical benefits in such
patients. Patients and Methods: Two case reports are presented
illustrating the efficacy of erlotinib in patients with recurrent
brain metastases and parallel thoracic progression. Results: Both
patients showed lasting partial remissions in the brain and lung,
and clinical symptom improvement. Conclusion: The observed survival
times of above 18 and 15 months, respectively, since occurrence of
cranial disease manifestation in line with the achieved
progression-free survival times of 9 and 6 months by the erlotinib
third-line therapy are remarkable. The use of targeted therapies
after whole-brain irradiation should be investigated more
systematically in prospective clinical trials.