1. Outcomes with non-small cell lung cancer and brain-only metastasis.
- Author
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Schmid S, Garcia M, Zhan L, Cheng S, Khan K, Chowdhury M, Sabouhanian A, Herman J, Walia P, Strom E, Brown MC, Patel D, Xu W, Shepherd FA, Sacher AG, Leighl NB, Bradbury PA, Liu G, and Shultz D
- Abstract
Background: We evaluated outcomes in non-small cell lung cancer (NSCLC) patients who presented with brain-only metastatic (BOM) disease overall and by EGFR/ALK mutation status., Methods: We analyzed clinico-demographic, treatment and survival data for all NSCLC patients who presented to our center between 2014 and 2016 with BOM as their first presentation of metastatic disease. Differences in overall survival (OS) were evaluated using log-rank tests for NSCLC wildtype (NSCLCwt ) versus NSCLC with an ALK-rearrangement/EGFR-mutation (NSCLCmut+)., Results: Of 109 patients with BOM, median age was 68 years; 51 % were female; 69 % Caucasian; 76 % ever-smoker; 76 % adenocarcinoma; and 25 % NSCLCmut+. While 41 patients (38 %) had subsequent brain-only progressive disease (PD), 22 (20 %) developed extracranial metastases. A higher proportion of NSCLCmut+ ( vs -wt) subsequently progressed outside the brain (37 % vs 15 %, p = 0.03). Median time-to-first-extracranial-metastases was 8.5 (NSCLCmut+ ) vs 21.0 months (NSCLCwt; p = 0.23).With 17.7 months median follow-up, median-OS was 15.9 months [95%CI: 11.5-21.3; all patients]; 12.3 [7.4-18.4; NSCLCwt] and 38.9 [21.3-not reached (NR); NSCLCmut+] (p = 0.09). In 33 of 80 patients with de novo BOM, the primary tumor was treated with surgery or radiotherapy. In patients with NSCLCwt, there was no OS benefit associated with local lung tumor treatment (p = 0.68), whereas in NSCLCmut + pts, local lung tumor treatment correlated with greater OS (median-OS NR vs 21.5 months; p = 0.05)., Conclusion: In patients with NSCLCwt with BOM, we observed a -predominant pattern of brain-only secondary progression, however patients with NSCLCmut + more often progressed extracranially. In patients with NSCLCmut+ and BOM, definitive primary tumor treatment correlated with improved survival., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Sabine Schmid reports a relationship with MSD, Merck, BMS, AstraZeneca (all paid to institution) that includes: consulting or advisory. Sabine Schmid reports a relationship with 10.13039/100004325AstraZeneca, 10.13039/100014554Janssen, 10.13039/100008021BMS, 10.13039/100014554Janssen (all paid to institution) that includes: funding grants. Sabine Schmid reports a relationship with Swiss Cancer League that includes: funding grants. Sabine Schmid reports a relationship with Takeda, MSD, Amgen that includes: travel reimbursement. Geoffrey Liu reports a relationship with Boehringer Ingelheim, 10.13039/100004325AstraZeneca, 10.13039/100008021Bristol Myers Squibb, 10.13039/100004334Merck, 10.13039/100016040Takeda, 10.13039/100004319Pfizer, Hoffman La Roche, 10.13039/100006483Abbvie, 10.13039/100004755EMD Serono, Eli Lilly (all insitutional) that includes: consulting or advisory and funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)
- Published
- 2024
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