Author of

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  P2.14 - Targeted Therapy (ID 183)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Targeted Therapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31561

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    P2.14-41 - Risk Factors for Brain Metastasis in Patients with EGFR Mutant Non-Small Cell Lung Cancer (ID 1036)

    10:15 - 18:15  |  Author(s): Masahiro Seike
    • Abstract
    • Slides

    Background
    

    Brain metastasis is associated with a poor prognosis in patients with EGFR mutant non-small cell lung cancer (NSCLC). EGFR tyrosine kinase inhibitors (TKIs) may be an effective treatment, but their influence on brain metastasis development is unclear. We aimed to identify risk factors for brain metastasis in patients with EGFR-mutant NSCLC.

    Method
    

    This retrospective study included 166 consecutive advanced NSCLC patients with EGFR major mutations (Ex 21 L858R or Ex 19 del) who received EGFR–TKI monotherapy at the Nippon Medical School Hospital and Nippon Medical School Tamanagayama Hospital from November 2010 to June 2018. Patients who had brain metastases before EGFR–TKI monotherapy were excluded. We evaluated the cumulative actuarial incidence of brain metastases by Gray’s test, univariate and multivariate analyses.

    Result
    

    The median age was 72 years (range, 26-95 years), the majority of patients were female (n=103), and most patients had adenocarcinoma (n=153). Patients carried either an EGFR L858R (n=88) or 19del (n=78) mutation, and had been treated with gefitinib (n=97), erlotinib (n=22) or afatinib (n=47). The time to brain metastasis did not significantly differ between the three EGFR-TKI groups. The time to brain metastasis was significantly shorter in patients <75 years than >75 years (29.0 months versus not reached; HR 4.70; 95% CI 1.72-12.87). Univariate and multivariate analyses showed that age <75 years and non-adenocarcinoma histology were significant predictors of brain metastasis. In patients <75 years, the time to brain metastasis in patients who underwent EGFR-TKI dose reduction or intermittent treatment was significantly shorter than patients with constant EGFR-TKI treatment (24.9 versus 39.9 months; HR 2.40; 95% CI 1.10-5.22).

    Conclusion
    

    Age <75 years is a risk factor for brain metastasis in patients with EGFR mutant NSCLC. We do not recommend EGFR–TKI dose reduction or intermittent administration in these patients.

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