Details

Autor(en) / Beteiligte

• Sperduto, Paul W., MD, MPP, FASTRO
• Yang, T. Jonathan, MD
• Beal, Kathryn, MD
• Pan, Hubert, MD
• Brown, Paul D., MD
• Bangdiwala, Ananta, MS
• Shanley, Ryan, MS
• Yeh, Norman, MD
• Gaspar, Laurie E., MD, MBA, FASTRO
• Braunstein, Steve, MD, PhD
• Sneed, Penny, MD
• Boyle, John, MD
• Kirkpatrick, John P., MD, PhD
• Mak, Kimberley S., MD
• Shih, Helen A., MD
• Engelman, Alex, MD
• Roberge, David, MD
• Arvold, Nils D., MD
• Alexander, Brian, MD
• Awad, Mark M., MD, PhD
• Contessa, Joseph, MD
• Chiang, Veronica, MD
• Hardie, John, MD, PhD
• Ma, Daniel, MD
• Lou, Emil, MD, PhD
• Sperduto, William, BA
• Mehta, Minesh P., MD, FASTRO

Titel

The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients with Adenocarcinoma of the Lung and Brain Metastases

Ist Teil von

• International journal of radiation oncology, biology, physics, 2016-10, Vol.96 (2), p.406-413

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Purpose Lung cancer remains the most common cause of both cancer mortality and brain metastases (BM). The purpose of this study was to assess the effect of gene alterations and tyrosine kinase inhibition (TKI) on median survival (MS) and cause of death (CoD) in patients with BM from lung adenocarcinoma (L-adeno). Methods A multi-institutional retrospective database of L-Adeno patients and newly diagnosed BM between 2006-2014 was created. Demographics, gene alterations, treatment, MS and CoD were analyzed. Treatment patterns and outcomes were compared to prior trials. Results Of 1521 L-adeno patients, 816 (54%) had known alteration status. Gene alteration rates were 29, 10, 26% for EGFR, ALK, KRAS, respectively. Time from primary diagnosis to BM for EGFR -/+ was 10/15 months (p=0.02) and for ALK -/+ was 10/20 (p<0.01) months, respectively. MS for the group overall (n=1521) was 15 months. MS from first treatment for BM for EGFR and ALK -, EGFR +, ALK + were 14, 23 (p<0.01), 45 (p<0.0001) months, respectively. MS after BM for EGFR + patients who did/did not receive tyrosine kinase inhibition prior to BM was 17/30 (p<0.01) months, respectively, but risk of death was not statistically different between TKI-naïve patients who did/did not receive TKI after the diagnosis of BM ( EGFR/ALK hazard ratios: 1.06 (p=0.84)/1.60 (p=0.45), respectively). CoD was non-neurologic in 82% of patients with known CoD. Conclusion EGFR and ALK gene alterations are associated with delayed onset of BM and longer MS relative to patients without these alterations. CoD was overwhelmingly non-neurologic in patients with known CoD.