Risk factors of metachronous brain metastasis in patients with EGFR-mutated advanced non-small cell lung cancer

被引:17
|
作者
Ouyang, Wen [1 ]
Yu, Jing [1 ]
Zhou, Yan [1 ]
Hu, Jing [1 ]
Huang, Zhao [1 ]
Zhang, Junhong [1 ,2 ,3 ]
Xie, Conghua [1 ,2 ,3 ]
机构
[1] Wuhan Univ, Dept Radiat & Med Oncol, Zhongnan Hosp, 169 Donghu Rd, Wuhan 430071, Hubei, Peoples R China
[2] Wuhan Univ, Hubei Key Lab Tumor Biol Behav, Zhongnan Hosp, Wuhan, Peoples R China
[3] Wuhan Univ, Hubei Clin Canc Study Ctr, Zhongnan Hosp, Wuhan, Peoples R China
基金
中国国家自然科学基金;
关键词
Non-small cell lung cancer; Epidermal growth factor receptor; Brain metastases; Risk factor; OSIMERTINIB; THERAPY; TKI; INHIBITORS; GEFITINIB; ERLOTINIB; FAILURE; RTOG; RPA;
D O I
10.1186/s12885-020-07202-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundNSCLC patients with EGFR mutation were at a higher incidence of developing brain metastasis (BM). Patients with BM are associated with high mortality. Reducing BM incidence becomes increasingly significant for NSCLC patients to achieve prolonged survival. The aim of the study was to explore the possible risk factors of developing metachronous BM during EGFR-TKIs treatment, and to identify the potential candidates for prophylactic cranial irradiation (PCI) or the first-line Osimertinib treatment.MethodsA total of 157 consecutive EGFR-mutated advanced NSCLC patients without BM at initial diagnosis in our institution from 2012 and 2018 were retrospectively reviewed. Comparisons of OS were performed based on BM status. The cumulative incidence of metachronous BM was calculated by the Kaplan-Meier method, and the independent risk factors of metachronous BM were investigated by multivariate analysis.ResultsPatients developing metachronous BM had worse survival (mOS: 22.1months) than patients not-developing BM (mOS: 44.8months). Moreover, the multivariate analysis indicated that age <= 49years (P=0.035), number of extracranial metastases (P=0.013), and malignant pleural effusion (P=0.002) were independent risk factors of metachronous BM. Furthermore, the 1-year actuarial incidence of developing metachronous BM in patients with no risk factor (n=101), 1 risk factor (n=46), and 2 risk factors (n=10) were 7.01, 14.61, and 43.75%, respectively (P<0.001).ConclusionsPatients developing metachronous BM during EGFR-TKIs treatment have worse outcomes. Our results suggested that EGFR-mutated advanced NSCLC patients with <greater than or equal to>1 risk factors were candidates for PCI or the first-line Osimertinib treatment.
引用
收藏
页数:11
相关论文
共 50 条
  • [21] Capmatinib plus nazartinib in patients with EGFR-mutated non-small cell lung cancer
    Felip, Enriqueta
    Metro, Giulio
    Soo, Ross A.
    Wolf, Juergen
    Solomon, Benjamin J.
    Tan, Daniel S. W.
    Ardizzoni, Andrea
    Lee, Dae Ho
    Sequist, Lecia V.
    Barlesi, Fabrice
    Ponce-Aix, Santiago
    Abreu, Delvys Rodriguez
    Campelo, Maria Rosario Garcia
    Sprauten, Mette
    Djentuh, Leslie O'Sullivan
    Smith, Nathalie
    Jary, Aline
    Belli, Riccardo
    Glaser, Sabine
    Zou, Mike
    Cui, Xiaoming
    Giovannini, Monica
    Yang, James Chih-Hsin
    EUROPEAN JOURNAL OF CANCER, 2024, 208
  • [22] Investigating osimertinib plus chemotherapy in EGFR-mutated advanced non-small cell lung cancer
    Spagnuolo, Alessia
    Gridelli, Cesare
    EXPERT OPINION ON PHARMACOTHERAPY, 2025,
  • [23] Early dose reduction of osimertinib in advanced EGFR-mutated non-small cell lung cancer
    Ferreira, Marion
    Ebia, Matthew I.
    Reckamp, Karen L.
    ANTI-CANCER DRUGS, 2024, 35 (07) : 672 - 679
  • [24] A Single-Institution Experience of Afatinib in Patients with EGFR-Mutated Advanced Non-Small Cell Lung Cancer
    Minemura, Hiroyuki
    Yokouchi, Hiroshi
    Hirai, Kenichiro
    Koizumi, Tatsuhiko
    Kanazawa, Kenya
    Tanino, Yoshinori
    Munakata, Mitsuru
    JOURNAL OF THORACIC ONCOLOGY, 2017, 12 (01) : S1230 - S1231
  • [25] Upfront osimertinib in EGFR-mutated non-small cell lung cancer: is brain still a sanctuary?
    Leonetti, Alessandro
    Facchinetti, Francesco
    Tiseo, Marcello
    ANNALS OF TRANSLATIONAL MEDICINE, 2018, 6
  • [26] Pharmacokinetics of gefitinib in elderly patients with EGFR-mutated advanced non-small cell lung cancer: a prospective study
    Nio, Yuta
    Ishida, Hiroo
    Matsumoto, Natsumi
    Kusumoto, Sojiro
    Kubota, Yutaro
    Tsunoda, Takuya
    Sasaki, Yasutsuna
    Fujita, Ken-ichi
    BMC PULMONARY MEDICINE, 2022, 22 (01)
  • [27] Pharmacokinetics of gefitinib in elderly patients with EGFR-mutated advanced non-small cell lung cancer: a prospective study
    Yuta Nio
    Hiroo Ishida
    Natsumi Matsumoto
    Sojiro Kusumoto
    Yutaro Kubota
    Takuya Tsunoda
    Yasutsuna Sasaki
    Ken-ichi Fujita
    BMC Pulmonary Medicine, 22
  • [28] Effectiveness of osimertinib plus chemotherapy and avastin for EGFR-mutated advanced non-small cell lung cancer with brain metastases
    Qin, H.
    Wang, S.
    Gao, F.
    Zeng, Z.
    Liu, X.
    ANNALS OF ONCOLOGY, 2021, 32 : S967 - S967
  • [29] Stratifying Risk in Oligoprogressive EGFR-Mutated Non-Small Cell Lung Cancer: The Role of ctDNA
    Arrieta, O.
    Guijosa, A.
    Heredia, D.
    Davila-Dupont, D.
    Rios-Garcia, E.
    JOURNAL OF THORACIC ONCOLOGY, 2024, 19 (10) : S323 - S324
  • [30] EGFR mutation tracking predicts survival in advanced EGFR-mutated non-small cell lung cancer patients treated with osimertinib
    Buder, Anna
    Hochmair, Maximilian J.
    Setinek, Ulrike
    Pirker, Robert
    Filipits, Martin
    TRANSLATIONAL LUNG CANCER RESEARCH, 2020, 9 (02) : 239 - +