288MO - Brain-only oligometastatic cancer patients present with longer overall survival than patients with extracranial involvement

Background

The incidence of brain-only oligometastatic diseases have been described to be increasing. Therefore, we aimed to investigate the clinical course of patients with BM as the only site of metastatic disease.

Methods

6083 patients with BM from different solid tumors treated between 1989-2021 at the Medical University of Vienna were identified from the Vienna Brain Metastasis Registry. Patients with one BM as the only metastatic site were classified as brain-only oligometastatic, whereas patients with extracranial and intracranial metastatic lesions were classified as poly-metastatic. A retrospective analyses was performed.

Results

1299/6083 (21.4%;[56.4% male; 43.6% female; median age 62 years]) patients presented with brain-only oligometastatic disease at time of BM diagnosis. Brain-only oligometastatic disease was most frequently observed in lung cancer (67.0%) followed by breast cancer (9.0%),melanoma (4.3%), cancer of unknown primary (4.5%), colorectal cancer (4.3%), renal cell carcinoma (3.2%), and others (7.7%) (p>0.001; chi-square test). The single BM as the only metastatic site was synchronously diagnosed with the primary tumor in 43.8% (569/1299) of patients. The median time from diagnosis of primary tumor to diagnosis of BM was significantly longer in poly-metastatic patients than in brain-only oligometastatic patients (25 vs. 17 months; p-value <0.001; log-rank test). Patients with brain-only oligometastatic disease showed a significantly longer median overall survival from diagnosis of BM compared to poly-metastatic patients (11 vs. 6 months; p< 0.001; log-rank test). Furthermore, 22.0% (286/1299) of patients with brain-only oligometastatic disease had long-term survival of >24 months, while only 11.0% (526/4784) of poly-metastatic patients presented with similar favorable survival (p<0.001; chi-square test).

Conclusions

Patients with brain only oligometastatic disease present with a more favorable survival prognosis than patients with additional extracranial involvement. Multidisciplinary treatment planning should be encouraged in patients with brain-only oligometastatic disease to address the high proportion of patients surviving more than 24 months.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

A. Steindl: Financial Interests, Personal, Other: Lilly. M. Preusser: Financial Interests, Personal, Advisory Board: Bayer, Bristol Myers Squibb, Novartis, Gerson Lehrman, CMC Contrast, Glaxo Smith Kline, Mundipharma, Roche, BMJ Journals, MedMedia, AstraZeneca, AbbVie, Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dohme, Tocagen, Adastra, Gan & Lee Pharmaceuticals; Financial Interests, Institutional, Research Grant, Clinical Trials and research: Boehringer-Ingelheim, Bristol Myers Squibb, Roche, Daiichi Sankyo, Merck Sharp & Dohme, Novocure, Glaxo Smith Kline, AbbVie; Non-Financial Interests, Leadership Role, Brain Tumor Group Chair: EORTC; Non-Financial Interests, Leadership Role, EANO President: EANO. A.S.S. Berghoff: Financial Interests, Personal, Invited Speaker: Roche, Bristol Myers Squibb, Merck, AstraZeneca; Financial Interests, Personal, Advisory Board: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: Daiichi Sankyo, Roche. All other authors have declared no conflicts of interest.