In their correspondence, Zhouguang Hui and colleagues cite National Comprehensive Cancer Network guidelines and suggest that icotinib could have been predicted to outperform whole-brain irradiation (WBI) before our BRAIN trial.¹ They also suggest that switching patients in the WBI group who did not receive chemotherapy to icotinib only after disease progression is not in accordance with standard treatment for stage IV non-small-cell lung cancer (NSCLC). However, before 2012 when the trial was designed (and even at the time of writing this), there were no phase 3 randomised controlled trials to assess the efficacy of frontline EGFR-tyrosine kinase inhibitors (TKIs) on brain metastases² and no evidence of significant differences between first-line and second-line EGFR-TKIs.

中文翻译：

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脑研究：很难下结论–作者的答复

在他们的通信中，周光辉及其同事引用了美国国家综合癌症网络指南，并建议在我们的BRAIN试验之前，可以预测到icotinib的性能要优于全脑辐射（WBI）。¹他们还建议将WBI组中仅在疾病进展后才接受化学疗法的患者转用依替替尼，这与IV期非小细胞肺癌（NSCLC）的标准治疗方法不一致。但是，在2012年设计该试验之前（甚至在撰写本文时），还没有3期随机对照试验来评估前线EGFR酪氨酸激酶抑制剂（TKI）对脑转移²的疗效，并且没有证据表明一线和二线EGFR-TKI之间存在显着差异。