Author of

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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

  • 26330

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    P1.01-100 - Concurrent Brain Radiotherapy and EGFR-TKI Have Better Survival Benefits in Patients with Brain Metastases from EGFR-Mutant NSCLC (ID 14392)

    16:45 - 18:00  |  Author(s): Shuiyun Han
    • Abstract

    Background
    

    Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) has intracranial activity in EGFR-mutant Non-Small Cell Lung Cancer (NSCLC). The optimal timing of brain radiotherapy and appropriate patients who need early brain radiotherapy remains controversial. We performed a retrospective analysis of patients with brain metastases (BM) from EGFR-mutant NSCLC to evaluate the preferred treatment of EGFR-TKIs in this population.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    Of 128 initial or recurrent patients diagnosed BM from EGFR-mutant NSCLC between Jan 1, 2012, and Dec 31, 2016, 68 EGFR-TKI combined with concurrent brain RT, and 60 upfront EGFR-TKI then brain RT. Disease-specific-graded prognostic assessment was similar between two groups. The Kaplan-Meier method and log-rank tests were used to compare overall survival rates and intracranial progression-free survival rates, and a bootstrapped Cox proportional hazards model was used to determine significant contributors to overall survival.

    4c3880bb027f159e801041b1021e88e8 Result
    

    Compared with upfront EGFR-TKI group, the median OS was significantly longer in EGFR-TKI combined with concurrent brain radiotherapy group (24.1 vs 17.8 months; P=0.046). According to multivariate COX analysis, KPS (≥ 70) and intracranial metastasis alone was associated with a longer OS. The median intracranial progression-free survival was significantly improved in patients receiving EGFR-TKI combined with concurrent brain radiotherapy compared with upfront EGFR-TKI (32.3 vs 10.2 months; P=0.022).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    The present study suggests that the use of EGFR-TKI combined with concurrent brain radiotherapy may result in superior OS in patients with brain metastases from EGFR-mutant NSCLC. Also, early brain radiotherapy could significantly reduce the risk of intracranial progression compared with EGFR-TKI alone. Participation in clinical trials is essential to define the indications and relative efficacy of concurrent management and EGFR-TKI alone in a selected population. We expect that further molecular biomarkers will improve estimation of prognosis and patient selection in the future.

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