463P - Real-world outcomes of patients with non-small cell lung cancer with and without intracranial metastatic disease: A retrospective cohort analysis

Background

Lung cancer is a significant health issue in Canada, often diagnosed late with poor prognosis. Non-small cell lung cancer (NSCLC), a prevalent subtype, frequently metastasizes to the brain, posing treatment challenges. Despite advancements, patients with intracranial metastatic disease (IMD) experience poor outcomes. This study aims to discern survival differences and treatment strategies in advanced NSCLC patients with and without IMD, offering crucial insights into IMD's impact on outcomes and therapies.

Methods

The aim was to describe NSCLC patients' characteristics and outcomes with and without IMD in Ontario, Canada. Using provincial databases, this retrospective cohort study included all NSCLC patients diagnosed between April 2010 and August 2019. Kaplan-Meier and Cox regression analyses compared OS between patient cohorts.

Results

Among 41,133 NSCLC patients, 22,465 (26.6%) with advanced disease were included. The mean age at diagnosis was 68.5 years, with adenocarcinoma representing over half of the cases (59.6%). The majority presented with stage 4 disease (87.4%) and with extracranial metastases (70.7%). The incidence of IMD was 28.6%, with 69.7% presenting synchronously. Most patients had died before the end of the follow-up period (92.8%). The median OS was 5.4 months (95% CI: 5.3–5.5). No significant difference in OS was observed between patients without versus with IMD (5.3 months vs. 5.7 months; p=0.2), nor within stage 3 patients with or without IMD (p=0.7). A diagnosis of IMD, early extracranial metastases, high stage, and male sex were associated with increased mortality risk, while targeted therapy, systemic therapy, chemotherapy, and cranial radiotherapy were linked to decreased mortality risk.

Conclusions

In summary, this study examines the clinical profiles and treatment outcomes of advanced NSCLC patients in Ontario, Canada, with and without IMD. Though overall survival is comparable, associations with mortality risk, like disease stage and treatments, stress the need for tailored therapeutic strategies. These results underscore the importance of personalized interventions to address IMD challenges in NSCLC management and improve patient outcomes.

Clinical trial identification

Editorial acknowledgement

During the preparation of this work the author(s) used ChatGPT n order to shorten character count. After using this tool/service, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

S. Das: Non-Financial Interests, Institutional, Leadership Role: Provincial Lead for CNS Cancers, Cancer Care ON; Financial Interests, Institutional, Funding: Oxford University Press, Research support from Synaptive and VPiX; Financial Interests, Institutional, Invited Speaker: Speaker for Congress of Neurological Surgery, American Association of Neurological Surgeons, American Board of Neurological Surgery; Financial Interests, Institutional, Advisory Board: Advisory Board of Subcortical Surgery Group. All other authors have declared no conflicts of interest.