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William T Purcell

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    P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.01-78 - The Incidence of Brain Metastases in ROS1-Rearranged Non-Small Cell Lung Cancer at Diagnosis and Following Progression on Crizotinib (ID 14164)

      16:45 - 18:00  |  Author(s): William T Purcell

      • Abstract
      • Slides


      Central nervous system (CNS) metastases in lung cancer are a frequent cause of morbidity and mortality. There are conflicting data on the incidence of CNS metastases in ROS1+ NSCLC at diagnosis and rate of CNS progression on crizotinib.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Retrospective review of 579 patients with stage IV NSCLC between June 2008 to December 2017 was performed. We captured presence of brain metastases and oncogene status. We measured progression free survival (PFS) and time to CNS progression in ROS1+ and ALK+ patients on crizotinib.

      4c3880bb027f159e801041b1021e88e8 Result

      We identified 33 ROS1+ and 115 ALK+ patients with advanced NSCLC. The incidence of brain metastases for treatment-naïve ROS1+ and ALK+ NSCLC was 36% (12/33) and 34% (39/115) respectively. There were no statistically significant differences in incidence of brain metastases across all oncogene sub-groups. Complete survival data was available for 19 ROS1+ and 83 ALK+ patients. Median PFS for the ROS1+ and ALK+ cohort was 11 and 8 months (p = 0.304). The CNS was the first site of progression for 52% (10/19) ROS1+ NSCLC and 43% (36/83) ALK+ NSCLC with no significant differences between the groups (p = 0.610). Among patients without CNS metastases prior to crizotinib therapy, 50% of ROS1+ and ALK+ patients developed CNS metastases as only site of progression at 24 and 21 months respectively.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Brain metastases are common in treatment-naïve stage IV ROS1+ NSCLC, though incidence does not differ from other oncogene cohorts. The CNS is a common first site of progression in patients with ROS1+ NSCLC on crizotinib. This study reinforces the need to develop CNS-penetrant TKIs for patients with ROS1+ NSCLC, similar to ALK+ NSCLC.


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