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A comparative analysis of EGFR mutation status in association with the efficacy of TKI in combination with WBRT/SRS/surgery plus chemotherapy in brain metastasis from non-small cell lung cancer.

Cai L, Zhu JF, Zhang XW, Lin SX, Su XD, Lin P, Chen K, Zhang LJ - J. Neurooncol. (2014)

Bottom Line: The median follow-up time was 28 months.The median overall survival, median progression-free survival of intracranial disease, and median progression-free survival of extracranial disease was significantly longer for patients with TKI treatment (31.9 vs 17.0 months, P < 0.0001; 19.8 vs 12.0 months, P < 0.0001; and 19.6 vs 12.3 months, P < 0.0001; respectively).In subgroup analysis within the TKI group, patients harboring EGFR mutations had better extracranial disease control (20.4 vs 14.1 months, P = 0.032).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.

ABSTRACT
We proposed to identify the efficacy of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) using whole brain radiotherapy (WBRT)/stereotactic radiosurgery (SRS)/surgery in brain metastases from patients with non-small cell lung cancer (NSCLC) and clarify the association between treatment outcome and EGFR gene mutation status. A total of 282 patients with NSCLC brain metastases who underwent WBRT/SRS/surgery alone or in combination with TKI were enrolled in our study from 2003-2013. Amplification mutation refractory system technology was used to determine the EGFR mutation status in 109 tissue samples. EGFR mutation detection was performed in 109 patients with tumor tissues. The EGFR positive rate was 50 % (55/109), including 26 exon 19 deletions and 24 L858R mutations. The median follow-up time was 28 months. The median overall survival, median progression-free survival of intracranial disease, and median progression-free survival of extracranial disease was significantly longer for patients with TKI treatment (31.9 vs 17.0 months, P < 0.0001; 19.8 vs 12.0 months, P < 0.0001; and 19.6 vs 12.3 months, P < 0.0001; respectively). In subgroup analysis within the TKI group, patients harboring EGFR mutations had better extracranial disease control (20.4 vs 14.1 months, P = 0.032). Administration of TKI agents with conventional therapy compared with conventional therapy alone might be beneficial for overall survival, progression-free survival of intracranial disease and progression-free survival of extracranial disease in patients with brain metastases from NSCLC independent of EGFR mutations.

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Related in: MedlinePlus

Survival curves in TKI and non-TKI groups, respectively. a Overall survival; b Progression-free survival of intracranial disease; c Progression-free survival of extracranial disease
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Related In: Results  -  Collection


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Fig1: Survival curves in TKI and non-TKI groups, respectively. a Overall survival; b Progression-free survival of intracranial disease; c Progression-free survival of extracranial disease

Mentions: With a median follow-up of 28 months (range, 22–34 months), 16 % (45) of patients were alive without evidence of disease progression, 17 % (48) were alive with disease, and 67 % (189) patients were dead due to disease progression. Overall, MOS, MPFSI, and MPFSE in the TKI group were 31.9 (95 % CI: 27.8–35.6), 19.8 (95 %CI: 16.8–22.8), and 19.6 (95 %CI: 16.4–22.8) months compared with 17.0 (95 % CI: 14.5–19.5) (P < 0.0001), 12.0 (95 %CI: 10.4–13.6) (P < 0.0001), and 12.3 (95 % CI: 10.4–14.2) (P < 0.0001) months in the non-TKI group, respectively (Fig. 1). A better outcome of MOS, MPFSI and MPFSE was observed in the TKI group compared to the non-TKI group independent from gene mutation status (Table 2).Fig. 1


A comparative analysis of EGFR mutation status in association with the efficacy of TKI in combination with WBRT/SRS/surgery plus chemotherapy in brain metastasis from non-small cell lung cancer.

Cai L, Zhu JF, Zhang XW, Lin SX, Su XD, Lin P, Chen K, Zhang LJ - J. Neurooncol. (2014)

Survival curves in TKI and non-TKI groups, respectively. a Overall survival; b Progression-free survival of intracranial disease; c Progression-free survival of extracranial disease
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4206296&req=5

Fig1: Survival curves in TKI and non-TKI groups, respectively. a Overall survival; b Progression-free survival of intracranial disease; c Progression-free survival of extracranial disease
Mentions: With a median follow-up of 28 months (range, 22–34 months), 16 % (45) of patients were alive without evidence of disease progression, 17 % (48) were alive with disease, and 67 % (189) patients were dead due to disease progression. Overall, MOS, MPFSI, and MPFSE in the TKI group were 31.9 (95 % CI: 27.8–35.6), 19.8 (95 %CI: 16.8–22.8), and 19.6 (95 %CI: 16.4–22.8) months compared with 17.0 (95 % CI: 14.5–19.5) (P < 0.0001), 12.0 (95 %CI: 10.4–13.6) (P < 0.0001), and 12.3 (95 % CI: 10.4–14.2) (P < 0.0001) months in the non-TKI group, respectively (Fig. 1). A better outcome of MOS, MPFSI and MPFSE was observed in the TKI group compared to the non-TKI group independent from gene mutation status (Table 2).Fig. 1

Bottom Line: The median follow-up time was 28 months.The median overall survival, median progression-free survival of intracranial disease, and median progression-free survival of extracranial disease was significantly longer for patients with TKI treatment (31.9 vs 17.0 months, P < 0.0001; 19.8 vs 12.0 months, P < 0.0001; and 19.6 vs 12.3 months, P < 0.0001; respectively).In subgroup analysis within the TKI group, patients harboring EGFR mutations had better extracranial disease control (20.4 vs 14.1 months, P = 0.032).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China.

ABSTRACT
We proposed to identify the efficacy of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) using whole brain radiotherapy (WBRT)/stereotactic radiosurgery (SRS)/surgery in brain metastases from patients with non-small cell lung cancer (NSCLC) and clarify the association between treatment outcome and EGFR gene mutation status. A total of 282 patients with NSCLC brain metastases who underwent WBRT/SRS/surgery alone or in combination with TKI were enrolled in our study from 2003-2013. Amplification mutation refractory system technology was used to determine the EGFR mutation status in 109 tissue samples. EGFR mutation detection was performed in 109 patients with tumor tissues. The EGFR positive rate was 50 % (55/109), including 26 exon 19 deletions and 24 L858R mutations. The median follow-up time was 28 months. The median overall survival, median progression-free survival of intracranial disease, and median progression-free survival of extracranial disease was significantly longer for patients with TKI treatment (31.9 vs 17.0 months, P < 0.0001; 19.8 vs 12.0 months, P < 0.0001; and 19.6 vs 12.3 months, P < 0.0001; respectively). In subgroup analysis within the TKI group, patients harboring EGFR mutations had better extracranial disease control (20.4 vs 14.1 months, P = 0.032). Administration of TKI agents with conventional therapy compared with conventional therapy alone might be beneficial for overall survival, progression-free survival of intracranial disease and progression-free survival of extracranial disease in patients with brain metastases from NSCLC independent of EGFR mutations.

Show MeSH
Related in: MedlinePlus