Abstract 491P
Background
Leptomeningeal metastases (LM) remain challenging for patients with non-small cell lung cancer. EGFR mutation shows a higher incidence rate of LM with poor prognosis. 3rd generation TKI has better cerebral-spinal fluid(CSF) penetration and may be a promising treatment. Here we collected LM clinical features and outcome in EGFR-mutant lung adenocarcinoma in high EGFR mutation prevalence area.
Methods
This is a retrospective observational cohort study, conducted in a tertiary medical center in Taiwan. Patients with newly diagnosed advanced lung adenocarcinoma with common EGFR mutation were enrolled. LM were diagnosed by brain imaging study or cytology study of CSF analysis. Patients without initial brain MRI imaging or patients who underwent CNS surgery initially were excluded. All the data is valid up to Dec 31, 2017.
Results
From 2013 to 2015, a total of 283 patients was included. All patients were treated with first-line TKIs as systemic treatment initially. Thirty-four patients had LM, accounting for 12.0% (34/283) of this cohort. Only four patients in the LM group (11.7%) received CSF study, and three of them showed malignant cells in their CSF. Patients with LM had median overall survival(OS) 26.2 months, whereas patients with brain tumor progression had median OS 42.3 months. (p = 0.002) For patients with LM, the median OS after LM is 5.1 months. Patients with younger age(HR0.63[0.45-0.90], p = 0.01) and initial M1b(HR 2.86[1.81-4.53], p < 0.001) were associated with higher risk or intracranial progression. Among 34 patients, 6 patients received 3rd generation TKI and revealed significant better OS than those without 3rd TKI. (OS 15.3 months vs 3.7 months, p = 0.03).
Conclusions
LM show poor prognosis for patients with EGFR-mutant lung adenocarcinoma, compared with other types of brain metastases. Younger age and initial M1b associated with higher risk. Patients with 3rd generation TKI may bring benefit to these patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Taipei Veterans General Hospital.
Disclosure
C-H. Chiu: Honoraria (self): AstraZeneca; Honoraria (self): Boehringer Ingelheim; Honoraria (self): Roche. All other authors have declared no conflicts of interest.
Resources from the same session
447P - Hypomagnesaemia: An unnoticed problem in lung cancer patients treated with concurrent chemoradiation
Presenter: Sharif Ahmed
Session: Poster display session
Resources:
Abstract
448P - Incidence and severity of chemotherapy induced peripheral neuropathy in geriatric population who are receiving chemotherapy
Presenter: Alekhya Mandepudi
Session: Poster display session
Resources:
Abstract
449P - Utility of screening tool for assessment of chemotherapy induced peripheral neuropathy in cancer patients
Presenter: PRUTHVI Paibhavi
Session: Poster display session
Resources:
Abstract
450P - Supportive care to control nausea and dizziness in malignant tumours: A systematic review
Presenter: Rainer Spiegel
Session: Poster display session
Resources:
Abstract
451P - The safety of ramucirumab without H1-antihistamines as a premedication in patients with solid cancers: A retrospective study
Presenter: Nobuhiro Hattori
Session: Poster display session
Resources:
Abstract
452P - Expression of erythropoietin receptor in patient with anemia related chemotherapy and its correlation with absolute reticulocyte count
Presenter: Irza Wahid
Session: Poster display session
Resources:
Abstract
453P - Body mass index did not correlate with short term overall survival in breast cancers
Presenter: Jungsun Lee
Session: Poster display session
Resources:
Abstract
454P - Predictors of severity and comparison of CTCAE V3.0 vs V4.3 in assessing chemotherapy induced extravasation injuries
Presenter: Sangana Reddy
Session: Poster display session
Resources:
Abstract
455P - Assessment of nutritional status and quality of life among cancer patients undergoing chemotherapy
Presenter: Sri Prathima
Session: Poster display session
Resources:
Abstract
456P - Use of gamma irradiated bone allografts in treatment of various bone tumours
Presenter: Anchal Mishra
Session: Poster display session
Resources:
Abstract