Abstract 696P
Background
Clinically, it is controversial whether local therapy for brain metastases (BMs) can improve the survival of patients with NSCLC.
Methods
A cohort of NSCLC patients with BMs was retrospectively assembled and categorized. The patients in the local-therapy group were recipients of both regional interventions for BMs and systemic treatments, whereas the control group received systemic therapy exclusively. Statistical analysis, including the Chi-square test and survival curve evaluation, was subsequently conducted to validate the study findings.
Results
From Sept 2021 to Sept 2023, a total of 75 patients were included in local-therapy group and 43 in control group. No significant differences were observed between the two groups in terms of gender, age, pathological subtype, driver gene mutation profile, the count of BMs, and the initial systemic therapies following discovery of BMs. As of July 10, 2024, the median PFS was 21.25 months (95% CI 16.06-26.44m) in local-therapy group and 17.96 months (95% CI 10.10-25.83m) in control group (hazard ratio 1.14 [95% CI 0.76-1.72], p=0.536). The median OS was 58.79 months (95% CI 49.34-68.24m) in local-therapy group and 46.79 months (95% CI 32.48-61.09m) in control group (hazard ratio 0.79 [95% CI 0.45-1.40], p=0.387). In a subgroup analysis of patients with EGFR mutations, the median PFS was 20.75 months (95% CI 15.96-25.54m) in local-therapy group and 17.18 months (95% CI 12.82-21.54m) in control group (hazard ratio 1.10 [95% CI 0.68-1.78], p=0.709). The median OS was 55.14 months (95% CI 30.70-79.59m) in local-therapy group and 41.11 months (95% CI 25.02-57.19m) in control group (hazard ratio 0.85 [95% CI 0.44-1.62], p=0.598). These findings collectively indicate that the local therapy of BMs does not confer a survival benefit to patients with NSCLC. Furthermore, our data revealed that local therapy alleviated central nervous system (CNS) symptoms in 66.67% (14/21) of patients experiencing such symptoms.
Conclusions
Local therapy cannot extend survival in NSCLC patients with BMs. Consequently, active local treatment should be withheld for patients experiencing asymptomatic BMs unless it is imperative to alleviate CNS symptoms.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.