Abstract 1002P
Background
Epidermal growth factor receptor (EGFR)-mutant lung cancers have a high risk of developing brain metastases (BM). Craniocerebral radiotherapy has been considered as cornerstone for treatment of BM while BRAIN clinical trial showed that EGFR-TKI alone has effect on craniocerebral metastases. However, whether EGFR-TKIs combined with craniocerebral radiotherapy can further increase the efficacy and improve the prognosis of patients still need to be further discussed. This retrospective study aimed to evaluate the difference in efficacy between targeted therapy alone and targeted combined radiotherapy in EGFR mutant lung adenocarcinoma patients with BM.
Methods
291 patients with advanced non-small cell lung cancer with EGFR mutations were enrolled in this retrospective cohort study. Propensity score matching (PSM) was conducted by using a nearest-neighbor algorithm (1:1) to adjust for demographical and clinical covariates. The patients were divided into two groups: EGFR-TKIs alone and EGFR-TKIs combined with craniocerebral radiotherapy. Intracranial progression-free survival (iPFS) and overall survival (OS) were calculated. Kaplan–Meier was used to compare iPFS and OS between the two groups. The brain radiotherapy contained WBRT, local radiotherapy, and WBRT+Boost.
Results
The median age at diagnosis was 54 (range, 28–81) years. A majority of the patients were women (57, 55.9%) and non-smokers (77, 75.5%). According to the matching results of PSM, we finally matched 51 pairs of patients. The median iPFS for EGFR-TKIs alone (n=37), EGFR-TKIs + craniocerebral radiotherapy (n=24) was 8.9 and 14.7 months, respectively (P=0.0334). And the median OS for EGFR-TKIs alone (n=52), EGFR-TKIs + craniocerebral radiotherapy (n=52) was 32.1 and 45.3 months, respectively (P=0.0106).
Conclusions
The present study showed that in EGFR-mutant lung adenocarcinoma patients with BM, targeted therapy combined with craniocerebral radiotherapy is optimal treatment mode for this subgroup of patients.
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.