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Miyawaki T, Kenmotsu H, Yabe M, et al. Rechallenge with previously administered epidermal growth factor receptor-tyrosine kinase inhibitors in EGFR-mutated non-small cell lung cancer with leptomeningeal metastasis. Invest New Drugs. 2021;39(6):1732-1741doi: 10.1007/s10637-021-01140-3.
Miyawaki, T., Kenmotsu, H., Yabe, M., Kodama, H., Nishioka, N., Miyawaki, E., Mamesaya, N., Kobayashi, H., Omori, S., Wakuda, K., Ono, A., Deguchi, S., Mitsuya, K., Naito, T., Murakami, H., Mori, K., Harada, H., Hayashi, N., Takahashi, K., & Takahashi, T. (2021). Rechallenge with previously administered epidermal growth factor receptor-tyrosine kinase inhibitors in EGFR-mutated non-small cell lung cancer with leptomeningeal metastasis. Investigational new drugs, 39(6), 1732-1741. https://doi.org/10.1007/s10637-021-01140-3
Miyawaki, Taichi, et al. "Rechallenge with previously administered epidermal growth factor receptor-tyrosine kinase inhibitors in EGFR-mutated non-small cell lung cancer with leptomeningeal metastasis." Investigational new drugs vol. 39,6 (2021): 1732-1741. doi: https://doi.org/10.1007/s10637-021-01140-3
Miyawaki T, Kenmotsu H, Yabe M, Kodama H, Nishioka N, Miyawaki E, Mamesaya N, Kobayashi H, Omori S, Wakuda K, Ono A, Deguchi S, Mitsuya K, Naito T, Murakami H, Mori K, Harada H, Hayashi N, Takahashi K, Takahashi T. Rechallenge with previously administered epidermal growth factor receptor-tyrosine kinase inhibitors in EGFR-mutated non-small cell lung cancer with leptomeningeal metastasis. Invest New Drugs. 2021 Dec;39(6):1732-1741. doi: 10.1007/s10637-021-01140-3. Epub 2021 Jul 14. PMID: 34259953.
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Invest New Drugs. 2021 Dec;39(6):1732-1741. doi: 10.1007/s10637-021-01140-3. Epub 2021 Jul 14.

Rechallenge with previously administered epidermal growth factor receptor-tyrosine kinase inhibitors in EGFR-mutated non-small cell lung cancer with leptomeningeal metastasis.

Investigational new drugs

Taichi Miyawaki, Hirotsugu Kenmotsu, Michitoshi Yabe, Hiroaki Kodama, Naoya Nishioka, Eriko Miyawaki, Nobuaki Mamesaya, Haruki Kobayashi, Shota Omori, Kazushige Wakuda, Akira Ono, Shoichi Deguchi, Koichi Mitsuya, Tateaki Naito, Haruyasu Murakami, Keita Mori, Hideyuki Harada, Nakamasa Hayashi, Kazuhisa Takahashi, Toshiaki Takahashi

Affiliations

  1. Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
  2. Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
  3. Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan. [email protected].
  4. Division of Neurosurgery, Shizuoka Cancer Center, Shizuoka, Japan.
  5. Division of Clinical Research Management Office, Shizuoka Cancer Center, Shizuoka, Japan.
  6. Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan.

PMID: 34259953 DOI: 10.1007/s10637-021-01140-3

Abstract

Objectives In EGFR-mutated non-small cell lung cancer (NSCLC) patients, approximately 80-90% of leptomeningeal metastasis (LM) develops after failed initial treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (EGFR-TKI). However, the efficacy of rechallenging with previously administered EGFR-TKIs in patients with EGFR-mutated NSCLC and the LM that develops following EGFR-TKI treatment failure remains unknown. Materials and methods We retrospectively reviewed medical records of patients with EGFR-mutated NSCLC and LM, from November 2011 to August 2019. The patients were classified according to the LM treatment type: switched to previously unadministered EGFR-TKIs (Switch-TKI) or rechallenge with previously administered EGFR-TKIs (Rechallenge-TKI). Results In total, 50 patients treated with EGFR-TKI after LM diagnosis were included; 35 were treated with Switch-TKI and 15 with Rechallenge-TKI. The median overall survival (OS) from the time of LM diagnosis was 6.2 months in all study patients. According to the treatment type, the median OS from the time of LM diagnosis was 6.9 months in Switch-TKI patients and 4.9 months in Rechallenge-TKI patients. There was no significant difference in the OS between the Switch-TKI and Rechallenge-TKI groups (P = 0.864). Thirty-five patients were treated with erlotinib and 15 with osimertinib; Regardless of the type for EGFR-TKI, there was no significant difference in OS between patients treated with Switch-TKI and those treated with Rechallenge-TKI. Conclusion Rechallenge of previously administered EGFR-TKIs may be a therapeutic option for LM development after EGFR-TKI treatment failure in patients with EGFR-mutated NSCLC, not only switching to previously unadministered EGFR-TKIs.

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Keywords: EGFR mutation; EGFR-TKI; Leptomeningeal metastasis; Non-small cell lung cancer; Rechallenge EGFR-TKI

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