Osteoblastic Response in Patients with Non-small Cell Lung Cancer with Activating EGFR Mutations and Bone Metastases during Treatment with EGFR Kinase.

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Osteoblastic Response in Patients with Non-small Cell Lung Cancer with Activating EGFR Mutations and Bone Metastases during Treatment with EGFR Kinase Inhibitors Sascha Ansén, MD, Christopher Bangard, MD, Silvia Querings, PhD, Franziska Gabler, MSc, Matthias Scheffler, MD, Daniela Seidel, Beate Saal, PhD, Thomas Zander, MD, Lucia Nogová, MD, Karin Töpelt, MD, Eva Markert, MD, Erich Stoelben, MD, Karen Ernestus, MD, Roman K. Thomas, MD, Jürgen Wolf, MD Journal of Thoracic Oncology Volume 5, Issue 3, Pages 407-409 (March 2010) DOI: 10.1097/JTO.0b013e3181cf32aa Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 A, Baseline computed tomography (CT) before therapy with gefitinib shows an osteoblastic metastasis in the left iliac bone (arrow). B, Restaging CT 8 weeks after initiation of gefitinib therapy demonstrates progressive demarcation of the preexisting osteoblastic lesion in the left iliac bone (arrow). C, CT 6 months later at progression illustrates increased osteolysis in the former blastic area (arrow) compared with the baseline CT, shown in A, paralleling the overall tumor progression. Journal of Thoracic Oncology 2010 5, 407-409DOI: (10.1097/JTO.0b013e3181cf32aa) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 A, Baseline computed tomography before treatment with erlotinib shows an osteoblastic lesion in Th10. B, Corresponding to the clinical benefit after 7 weeks of erlotinib therapy, healing reaction of the osteoblastic lesion in Th10 is shown. The size of the lesion is not necessarily increased, but sclerosis is markedly amplified. Journal of Thoracic Oncology 2010 5, 407-409DOI: (10.1097/JTO.0b013e3181cf32aa) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 A, Baseline computed tomography before start of erlotinib therapy shows an insignificant vertebra Th11. B, “New” osteoblastic lesions in Th11 are shown in comparison with the baseline imaging 3 months after partial response to tyrosine kinase inhibitor treatment had been documented while the patient had still stable disease. C, At overall progression 5 months later, an enlargement of the osteoblastic lesions in Th11 could be identified. Note the blurry edges of the osteoblastic lesions at this time point. Journal of Thoracic Oncology 2010 5, 407-409DOI: (10.1097/JTO.0b013e3181cf32aa) Copyright © 2010 International Association for the Study of Lung Cancer Terms and Conditions