1283P - A comparative study of epidermal growth factor receptor tyrosine kinase inhibitor in treatment of patients with brain metastasis from non-small cell...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Presenter Lan-jun Zhang
Authors L. Zhang1, L. Cai2, J. Zhu1
  • 1Thoracic Surgery, Sun Yat-sen University Cancer Center, 510060 - Guangzhou/CN
  • 2Oncology, Sun Yat-sen University Cancer Center, 510060 - Guangzhou/CN

Abstract

Purpose

Brain metastasis (BM) presents 20-25% of patients with non-small cell lung cancer (NSCLC). Whole brain radiation therapy (WBRT) was considered as a standard therapy along with stereotactic radiosurgery (SRS), or surgical resection (SR) or chemotherapy (CXT). Median survival time ranged from 6.5-10 months for conventional therapy. In this study, we purposed to compare the outcomes of conventional therapy (CVT) combined with or without epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in the treatment for patients with BM from NSCLC.

Methods

A total of 275 NSCLC patients with BM were treated sequentially between Jan, 1999 and Nov, 2011 according to our institutional protocol. Of these 275 patients, 97 (35%) underwent EGFR-TKI combined with CVT (TKI + CVT), and 178 (65%) underwent CVT. All patients received WBRT. Both treatment groups were similar with regard to age, sex, smoking status, histological subtype, number and size of BM lesions, extracranial lesions and intracranial symptoms.

Results

Median overall survivals (MOS), median progress free survivals (MPFS), median progress free survivals of intracranial lesions (MPFSI) and median progress free survivals of extracranial lesions (MPFSE) were 28.2 (95% CI:22.3-34.1) and 13.7 (95% CI:11.4-15.9) months, 10.9 (95% CI:8.4-13.4) and 6.7 (95%CI:5.1-8.4) months, 18.7 (95%CI: 12.6-24.8) and 10.3 (95%CI:8.4-12.3) months, 11.1(95%CI:9.1-13.1) and 7.9 (95%CI:6.2-9.5) months for TKI + CTV and CTV groups, respectively. With TKI + CVT group, improved outcome was found to be significantly associated with no lymph node metastasis (P = 0.001) and adverse drug reaction (ADR) (P = 0.001) for MOS, MPFS, MPFSI and MPFSE. With CVT group, improved MOS was found to be associated with age <65yrs (P = 0.038), never smoking (P = 0.047), number of BM lesions <3 (P = 0.018), maximum diameter of lesion <3cm(P = 0.018), no extracranial lesions (P = 0.001), and no lymph node metastasis (P = 0.001). On multivariate analysis for TKI + CVT group, age (P = 0.023), smoking status (P = 0.004), extracranial lesions (P = 0.022), N staging (P = 0.002) and ADR (P = 0.005) retained statistical significance.

Conclusion

Patients with NSCLC and brain metastasis might benefit from treatment of EGFR-TKI in combination with conventional treatment.

Disclosure

All authors have declared no conflicts of interest.