Order of treatments in lung cancer which has spread to the brain

This study wanted to find out what works better in patients with lung cancer that has spread to the brain; performing radiotherapy and treatment with EGFR inhibitors one after the other, or performing radiotherapy and treatment with EGFR inhibitors at the same time. The study found that performing them at the same time had the best results.  

Epidermal growth factor receptor (EGFR) is found on some types of cell. It is involved in receiving signals from the body to tell the cell to grow. It is sometimes found in high numbers on some types of cancer cells. It is possible to use this receptor to target those cancer cells and stop them from growing. One type of cancer which commonly has EGFR in high numbers is non-small cell lung cancers. By targeting EGFR using an EGFR inhibitor, it is possible to kill the tumor. Radiotherapy is treatment known to shrink tumors, although it does have some severe side effects. Using both these treatments for lung cancer that has spread to the brain is common. However, it is not known in what order the treatment works best, or if it works best performing both treatments at the same time

This study had 105 patients. All the patients had lung cancer which had spread to the brain. The patients were split up into three groups. The first group had 39 patients in it, and these patients only received treatment with EGFR inhibitors. The second group had 34 patients in it. These patients received treatment with EGFR inhibitors and radiotherapy of the brain at the same time. The third group had 32 patients. These patients had radiotherapy of the brain first, then, once that was done, had treatment with EGFR inhibitors.  

66.7% of those who received only EGFR inhibitors had a reduction in the size of the tumors in the brain. Of the patients who received EGFR inhibitors and radiotherapy at the same time, 85.0% had a reduction in the size of the tumors in the brain. Of the patients who received EGFR inhibitors and radiotherapy one after the other, 75.0% had a reduction in the size of the tumors in the brain.

61.5% of those who received only EGFR inhibitors responded to treatment in some way. Of the patients who received EGFR inhibitors and radiotherapy at the same time, 76.5% responded to treatment in some way. Of the patients who received EGFR inhibitors and radiotherapy one after the other, 68.8% of patients responded to treatment in some way.

This study found that using EGFR inhibitors at the same time as radiotherapy was better than performing the treatments one after another in patients with lung cancer that has spread to the brain.

This is a small study. A group of people in this study who should have been tested are those who had EGFR treatment first, followed by radiotherapy.

Talk to your oncologist about your treatment plan.