Stereotactic Radiosurgery and Erlotinib in Treating Patients With Non-Small Cell Lung Cancer and Brain Metastases

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically confirmed non-small cell lung cancer (NSCLC) meeting the following criteria:
• * Fewer than 5 intraparenchymal brain metastases by gadolinium-enhanced MRI meeting the following criteria:
• * Maximum diameter ≤ 4.0 cm
• * If multiple lesions are present and one lesion is \> 3.0 cm, the remaining lesions must be ≤ 3.0 cm in maximum diameter
• * No metastases within 3 mm of the optic nerve or optic chiasm such that some portion of the optic nerve or chiasm would receive \> 9 Gy from radiosurgery
• * No metastases in the brainstem, midbrain, pons, or medulla
• No prior complete resection of a single brain metastasis or of all known brain metastases
• * Subtotal resection allowed provided residual disease is ≤ 4.0 cm in maximum diameter
• No clinical or radiographic evidence of unstable systemic progression (other than the study lesion\[s\]) within the past month
• * Patients with brain metastases at initial presentation do not require 1 month of scans documenting stable disease
• Isolated brain metastases with stable systemic disease allowed
• No leptomeningeal metastases by MRI and/or positive cerebrospinal fluid cytology
• PATIENT CHARACTERISTICS:
• Karnofsky performance status 60-100%
• Life expectancy ≥ 3 months
• ANC \> 1,000/mm³
• Platelet count \> 100,000/mm³
• Hemoglobin \> 10 g/dL
• PT and PTT normal
• AST \< 2 times upper limit of normal (ULN)
• Alkaline phosphatase \< 2 times ULN
• Total bilirubin \< 2 times ULN
• Lactic dehydrogenase \< 2 times ULN
• Serum creatinine \< 1.5 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for ≥ 2 weeks after completion of study therapy
• Neurologic function status 0-2
• No history of allergic reactions attributed to compounds of similar chemical or biologic composition to erlotinib hydrochloride
• No contraindication to MRI (e.g., cardiac pacemaker)
• No absolute contraindication to lumbar puncture
• PRIOR CONCURRENT THERAPY:
• See Disease Characteristics
• Prior systemic therapy allowed
• No prior cranial radiotherapy
• * Prior radiotherapy to noncranial sites allowed
• More than 1 week since prior intrathecal chemotherapy or prior treatment of leptomeningeal carcinoma
• No concurrent systemic therapy
• * Prior or current erlotinib hydrochloride for treatment of systemic disease allowed provided systemic disease has not progressed while on erlotinib hydrochloride
• No concurrent enzyme-inducing anticonvulsant
• * If patients are on an enzyme-inducing anticonvulsant (e.g., phenytoin, carbamazepine, or phenobarbital), the agent must be converted to a nonenzyme-inducing anticonvulsant before or at the start of erlotinib hydrochloride treatment
• No concurrent CYP3A4 inhibitors or inducers (e.g., Hypericum perforatum \[St. John wort\] or ketoconazole)
• No other concurrent investigational therapy