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 wholebrain irradiation should be investigated more systematically in prospective clinical trials.