Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster Discussion – CNS tumours

3331 - Impact of neurological symptom burden on the survival prognosis in a real-life cohort of patients with non-small cell lung cancer brain metastases

Date

28 Sep 2019

Session

Poster Discussion – CNS tumours

Presenters

Ariane Steindl

Citation

Annals of Oncology (2019) 30 (suppl_5): v143-v158. 10.1093/annonc/mdz243

Authors

A. Steindl1, S. Yadavalli2, K.A. Gruber1, M. Seiwald1, J.M. Frischer3, B. Gatterbauer3, K. Dieckmann4, C. Marosi1, G. Widhalm5, M. Preusser1, A.S. Berghoff1

Author affiliations

  • 1 Department Of Medicine I, Medical University of Vienna, 1090 - Vienna/AT
  • 2 Internal Medicine I, Medical University of Vienna, 1090 - Vienna/AT
  • 3 Neurosurgery, Medical University of Vienna, 1090 - Vienna/AT
  • 4 Department Of Radiotherapy, Medical University of Vienna, 1090 - Vienna/AT
  • 5 Department Of Neurosurgery, Medical University of Vienna, 1090 - Vienna/AT

Resources

Login to access the resources on OncologyPRO.

If you do not have an ESMO account, please create one for free.

Abstract 3331

Background

The high efficacy of targeted treatments in a- to oligosymptomatic non-small cell lung cancer (NSCLC) brain metastases (BM) revived the long discussion on BM screening. Therefore, we aimed to investigate the prognostic impact of symptomatic burden in patients with newly NSCLC BM in a large real-life cohort.

Methods

Patients with newly diagnosed NSCLC BM were identified from the Vienna Brain Metastasis Registry.

Results

1531 patients (male 57.4%, female 42.3%; median age 62 years) were available for further analysis. Neurological symptoms including neurological deficits (952/153; 62.2%), symptoms of increased intracranial pressure (456/153; 29.8%) and epileptic seizures (199/1531; 13.0%) were evident in 1125/1531 (73.5%) patients. Oligo-to asymptomatic BM were significantly more frequently observed in patients with synchronous diagnosis of BM and NSCLC (p < 0.001). Patients with oligo- to asymptomatic BM presented with a longer median overall survival after diagnosis of BM compared to patients with symptomatic BM (11 vs. 7 months; p < 0.001). In detail, presence of increased intracranial pressure and seizures showed no impact on survival prognosis (p > 0.05), while the median overall survival was significantly longer in patients without neurological deficits (11 vs. 7 months; p < 0.001): memory disorders (6 vs. 8 months; p > 0.05), ataxia (7 vs. 8; p = 0.041) and vertigo (6 vs. 9; p = 0.007). In multivariate analysis with DS-GPA (HR 1.41; 95% CI 1.33-1.50; p < 0.001), the presence of neurological symptoms was independently associated with survival prognosis from diagnosis of BM (HR 1.19; 95% CI 1.05-1.36; p = 0.007). Interestingly, the prognostic impact of neurological symptoms was more pronounced in patients with lower DS-GPA class II-IV (class II: 15 vs. 11; p = 0.002, class III: 10 vs. 6; p < 0.001, class IV: 6 vs. 3; p = 0.018) compared to patients with DS-GPA class I (19 vs. 14; p = 0.230).

Conclusions

Presence of neurological symptoms presented with a strong and independent association with survival prognosis from diagnosis of BM especially in patients with lower DS-GPA and should be further evaluated for inclusion in the prognostic assessment of patients with newly diagnosed NSCLC BM.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

M. Preusser: Research grant / Funding (self): Böhringer-Ingelheim; Honoraria (institution), Advisory / Consultancy, Research grant / Funding (self): GlaxoSmithKline; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Merck Sharp & Dome; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self): Roche; Honoraria (self), Advisory / Consultancy: Bristol-Myers Squibb; Honoraria (self), Advisory / Consultancy: Novartis; Honoraria (self), Advisory / Consultancy: Gerson Lehrman Group; Honoraria (self), Advisory / Consultancy: CMC Contrast; Honoraria (self), Advisory / Consultancy: Mundipharma; Honoraria (self), Advisory / Consultancy: AstraZeneca; Honoraria (self), Advisory / Consultancy: AbbVie; Honoraria (self), Advisory / Consultancy: Lilly; Honoraria (self), Advisory / Consultancy: Medahead; Honoraria (self), Advisory / Consultancy: Daiichi Sankyo. A.S. Berghoff: Honoraria (self), Advisory / Consultancy, Research grant / Funding (institution): Daiichi Sankyo; Honoraria (self), Advisory / Consultancy, Research grant / Funding (self), Travel / Accommodation / Expenses: Roche; Honoraria (self), Advisory / Consultancy: Bristol-Meyers Squibb; Honoraria (self), Advisory / Consultancy: Merck; Travel / Accommodation / Expenses: Amgen; Travel / Accommodation / Expenses: AbbVie. All other authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.