Whole Brain Radiation With or Without Erlotinib for Brain Metastases From Non-Small Cell Lung Cancer (RadEr)

Inclusion Criteria: Histologically or cytologically confirmed advanced non-small cell lung cancer (NSCLC) meeting 1 of the following criteria:

• Newly diagnosed multiple brain metastases not suitable for first-line chemotherapy
• Relapsed NSCLC with newly diagnosed multiple brain metastases

• Relapsed NSCLC after second-line or more chemotherapy regimens with newly diagnosed multiple brain metastases

  • Diagnosis of brain metastases confirmed by MRI (or CT if MRI is not available/possible) within the past 4 weeks
  • Symptoms attributable to brain metastases
  • Patients who have undergone craniotomy with incomplete resection are eligible
  • Clinician's opinion that whole-brain radiotherapy (WBRT) will be beneficial
  • ECOG PS 0-2
  • Age above 18 years
  • Serum bilirubin < 2 times upper limit of normal (ULN)
  • AST and ALT < 2 times ULN (< 5 times ULN if liver metastases are present)
  • Creatinine < 1.5 times ULN
  • Able to take oral medication
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception
  • No other prior or concurrent malignant disease likely to interfere with study treatment or comparisons

Exclusion Criteria:

• More than 3 sites (organ systems) of extracranial metastases
• Evidence of solitary brain metastasis on MRI that can be treated with surgical resection, radiosurgery, or stereotactic radiotherapy
• Evidence of other significant laboratory finding or concurrent uncontrolled medical illness, that in the opinion of the investigator, would interfere with study treatment or results comparison or render the patient at high risk for treatment complications