Researchers conducted a phase III clinical trial to compare two drugs, rezivertinib and gefitinib, for treating advanced lung cancer with specific genetic changes (EGFR mutations) that had spread to the brain. The study focused on 159 patients who had not received prior treatment and had stable brain metastases at the start. Patients were randomly assigned to receive either rezivertinib or gefitinib, and their brain scans were reviewed by independent experts who did not know which treatment they were getting.
The main finding was that rezivertinib delayed the time until brain metastases worsened. The median time was 24.9 months for patients on rezivertinib, compared to 15.2 months for those on gefitinib. This difference was statistically significant. The rate of brain tumor shrinkage was higher with rezivertinib (83.3%) than with gefitinib (76.9%), but this difference was not statistically significant, meaning it could be due to chance. The abstract reported a favorable safety profile with no new safety concerns.
It is important to be careful with these results. This analysis looked only at the patients in the larger trial who had brain metastases at the start. Results for patients without brain spread may be different. The study has not yet reported whether one drug helps patients live longer overall. The findings are promising for controlling brain metastases in this specific group, but more complete data from the full trial is needed.