Publication: Treatment outcomes and prognostic factors in patients with driver mutant non-small cell lung cancer and de novo brain metastases
Program
KU-Authors
KU Authors
Co-Authors
Kahraman, Seda
Karakaya, Serdar
Kaplan, Muhammed Ali
Goksu, Sema Sezgin
Ćzturk, Akın
İÅleyen, Zehra SucuoÄlu
Hamdard, Jamshid
Yıldırım, Sedat
DoÄan, Tolga
IÅık, Selver
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Abstract
Central nervous system (CNS) metastases can be seen at a rate of 30% in advanced stages for patients with non-small cell lung cancer (NSCLC). Growing evidence indicates the predictive roles of driver gene mutations in the development of brain metastases (BM) in recent years, meaning that oncogene-driven NSCLC have a high incidence of BM at diagnosis. Today, 3rd generation targeted drugs with high intracranial efficacy, which can cross the blood-brain barrier, have made a positive contribution to survival for these patients with an increased propensity to BM. It is important to update the clinical and pathological factors reflected in the survival with real-life data. A multi-center, retrospective database of 306 patients diagnosed with driver mutant NSCLC and initially presented with BM between between November 2008 and September 2022 were analyzed. The median progression-free survival (mPFS) was 12.25 months (95% CI, 10-14.5). While 254 of the patients received tyrosine kinase inhibitor (TKI), 51 patients received chemotherapy as first line treatment. The median intracranial PFS (iPFS) was 18.5 months (95% CI, 14.8-22.2). The median overall survival (OS) was 29 months (95% CI, 25.2-33.0). It was found that having 3 or less BM and absence of extracranial metastases were significantly associated with better mOS and iPFS. The relationship between the size of BM and survival was found to be non-significant. Among patients with advanced NSCLC with de novo BM carrying a driver mutation, long-term progression-free and overall survival can be achieved with the advent of targeted agents with high CNS efficacy with more conservative and localized radiotherapy modalities.
Source
Publisher
Nature Portfolio
Subject
Open label, ALK, Multicenter
Citation
Has Part
Source
Scientific Reports
Book Series Title
Edition
DOI
10.1038/s41598-024-56046-w