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Treatment outcomes and prognostic factors in patients with driver mutant non-small cell lung cancer and de novo brain metastases.
- Source :
-
Scientific reports [Sci Rep] 2024 Mar 09; Vol. 14 (1), pp. 5820. Date of Electronic Publication: 2024 Mar 09. - Publication Year :
- 2024
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Abstract
- Central nervous system (CNS) metastases can be seen at a rate of 30% in advanced stages for patients with non-small cell lung cancer (NSCLC). Growing evidence indicates the predictive roles of driver gene mutations in the development of brain metastases (BM) in recent years, meaning that oncogene-driven NSCLC have a high incidence of BM at diagnosis. Today, 3rd generation targeted drugs with high intracranial efficacy, which can cross the blood-brain barrier, have made a positive contribution to survival for these patients with an increased propensity to BM. It is important to update the clinical and pathological factors reflected in the survival with real-life data. A multi-center, retrospective database of 306 patients diagnosed with driver mutant NSCLC and initially presented with BM between between November 2008 and September 2022 were analyzed. The median progression-free survival (mPFS) was 12.25 months (95% CI, 10-14.5). While 254 of the patients received tyrosine kinase inhibitor (TKI), 51 patients received chemotherapy as first line treatment. The median intracranial PFS (iPFS) was 18.5 months (95% CI, 14.8-22.2). The median overall survival (OS) was 29 months (95% CI, 25.2-33.0). It was found that having 3 or less BM and absence of extracranial metastases were significantly associated with better mOS and iPFS. The relationship between the size of BM and survival was found to be non-significant. Among patients with advanced NSCLC with de novo BM carrying a driver mutation, long-term progression-free and overall survival can be achieved with the advent of targeted agents with high CNS efficacy with more conservative and localized radiotherapy modalities.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Prognosis
Retrospective Studies
ErbB Receptors genetics
Treatment Outcome
Protein Kinase Inhibitors pharmacology
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung genetics
Lung Neoplasms drug therapy
Lung Neoplasms genetics
Brain Neoplasms drug therapy
Brain Neoplasms genetics
Central Nervous System Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 14
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 38461209
- Full Text :
- https://doi.org/10.1038/s41598-024-56046-w