Figure 2

Data of primary tumor and brain metastases in a patient with non-small cell lung cancer. (A) Post-diagnosis kinetics of the primary tumor largest diameter, measured on follow-up computerized tomography images (inlet). This EGFR mutated patient was treated first with a tyrosine kinase inhibitor (erlotinib) then with several rounds of additional systemic treatments upon relapse (cytotoxic chemotherapy (docetaxel), re-challenge with erlotinib and a second cytotoxic agent (gemcitabine)), as indicated by arrows and dashed lines in the figure. The solid line corresponds to the model fit during treatment (tumor growth inhibition (TGI) model). (B) Growth kinetics of the brain metastases. The solid line corresponds to Gompertz growth predictions based on parameters estimated from the primary tumor size at diagnosis and histological type, using as initial condition the first observation of each BM. (C) Time course of the apparition of visible metastases. (D) Cerebral magnetic resonance image showing two brain metastases 48 months post-diagnosis (other brain lesions not visible on this slice). EGFR = Epithelial Growth Factor Receptor, TKI = Tyrosine Kinase Inhibitor, mTKI = maintenance Tyrosine Kinase Inhibitor, CT = (cytotoxic) chemotherapy. Time is in months from diagnosis.