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Poster Display session 1

5142 - Prognostic factors for non-small cell lung cancer patients with driver mutation negative and brain metastases (HOT 1701)

Date

28 Sep 2019

Session

Poster Display session 1

Topics

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Yoshihito Ohhara

Citation

Annals of Oncology (2019) 30 (suppl_5): v602-v660. 10.1093/annonc/mdz260

Authors

Y. Ohhara1, T. Kojima2, O. Honjo3, N. Yamada4, T. Sato2, M. Kunisaki5, K. Takamura6, T. Takashina7, N. Sukoh8, H. Tanaka9, Y. Kawai10, Y. Fujita11, F. Sugaya12, F. Hommura13, T. Harada14, H. Ryoichi15, I. Kinoshita1, T. Amano16, S. Oizumi4, H.D. Akita1

Author affiliations

  • 1 Department Of Medical Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, 060-8638 - Sapporo/JP
  • 2 Department Of Medical Oncology, KKR Sapporo Medical Center, 062-0931 - Sapporo/JP
  • 3 Department Of Respiratory Medicine, Sapporo Minami-Sanjo Hospital, 060-0063 - Sapporo/JP
  • 4 Department Of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, 003-0804 - Sapporo/JP
  • 5 5. first Department Of Medicine, Hokkaido University Hospital, 060-8648 - Sapporo/JP
  • 6 Department Of Respiratory Medicine, Obihiro-Kosei General Hospital, 080-0024 - Obihiro/JP
  • 7 7. department Of Respiratory Medicine, Iwamizawa Municipal General Hospital, 068-8555 - Iwamizawa/JP
  • 8 Department Of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, 063-0005 - Sapporo/JP
  • 9 Department Of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki/JP
  • 10 10. department Of Respiratory Medicine, Oji General Hospital, Tomakomai/JP
  • 11 Department Of Respiratory Medicine, National Hospital Organization Asahikiwa Medical Center, 070-8644 - Asahikawa/JP
  • 12 Department Of Respiratory Medicine, Teine Keijinkai Hospital, 006-0811 - Sapporo/JP
  • 13 13. department Of Respiratory Disease, Sapporo City General Hospital, Sapporo/JP
  • 14 14. center For Respiratory Diseases, JCHO Hokkaido Hospital, 062-8618 - Sapporo/JP
  • 15 Department Of Respiratory Medicine, Asahi General Hospital, 289-2511 - Asahi/JP
  • 16 16. clinical Research And Medical Innovation Center, Hokkaido University Hospital, Sapporo/JP

Resources

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Abstract 5142

Background

Non-small cell lung cancer (NSCLC) is characterized by a high incidence of brain metastasis (BM) and the prognosis of NSCLC patients with BM is poor. Previous study demonstrated four prognostic factors, which were age, poor PS, presence of extracranial metastases (ECM), and number of BM, in NSCLC patients with BM. This study aimed to identify prognostic factors and clarify the survival in NSCLC patients with BM at the time of a diagnosis.

Methods

A total of 566 NSCLC patients with BM from 15 institutions between January 2008 and December 2014. Among them, 176 patients had driver mutation, such as EGFR mutation and ALK-rearrangement, and 390 patients did not. This retrospective study focused on the 390 NSCLC patients without driver mutation, and identified clinical prognostic factors using Cox proportional hazards model. Moreover, we validated the disease specific Graded prognostic assessment (DS-GPA) in this cohort.

Results

Median OS was 7.6 months, respectively (95% confidence interval [CI]; 6.5-8.7, data cut-off; December 2018). Multivariate analyses demonstrated the following independent prognostic factors; gender male (P = 0.001), age > 64 years (P = 0.009), poor PS (P < 0.001), T factor (P = 0.001), N factor (P = 0.028), histological type of non-adenocarcinoma (P < 0.001), presence of ECM (P < 0.001), and number of BM (P = 0.023). The median survival of four patient groups according to DS-GPA demonstrated 4.1 (GPA 0-1.0, n = 146, 95% CI, 3.2-5.1), 8.3 (GPA 1.5-2.0, n = 136, 95% CI, 6.5-10.1), 12.5 (GPA 2.5-3.0, n = 96, 95% CI, 9.3-15.7), 21.4 (GPA 3.5-4.0, n = 12, 95% CI, 0-43.2) months, respectively.

Conclusions

Prognosis of NSCLC patients with EGFR, ALK negative and BM is poor. In addition to the known prognostic factors such as DS-GPA, this study shown that male, T factor, N factor, and histological type of non-adenocarcinoma, had a prognostic role in NSCLC patients with driver mutation negative and BM.

Clinical trial identification

UMIN000030313, 08/12/2017.

Editorial acknowledgement

Legal entity responsible for the study

Hokkaido Lung Cancer Clinical Study Group Trial: HOT.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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