Hi Nilesh,
You are right, there are a few PH II studies.
There is an Italian group who are using this quite frequently with Oligo-mets in Breast and NSCLC.
http://www.ncbi.nlm.nih.gov/pubmed/18798231
There are other Ph II trials as well
http://www.ncbi.nlm.nih.gov/pubmed/17987262
http://www.ncbi.nlm.nih.gov/pubmed/17596744
some use it concurrently with WBRT while some use it later as adjuvant.
Overall, it does add to few months improvement in Progression free survival and probably OS as claimed by a few groups.
As you can understand there are loads of inherent bias in these studies and many studies have incorporated many different primary sites, making interpretation on a person to person basis impossible.
However, in absence of any Phase III data, it becomes difficult to make any strong recommendation.
I would recommend an EGFR inhibitor — Erlotinib or Iressa which are also known to cross BBB.
level 5 evidence, what i can give you from a small audit…………
we have used it for 17 patients with brain mets —- 3 are alive more than 1 year
our median OS = 7 months
These EGFR agents are licensed in NSCLC as you may be aware.
