Author of

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  P2.16 - Treatment in the Real World - Support, Survivorship, Systems Research (ID 187)

  • Event: WCLC 2019
  • Type: Poster Viewing in the Exhibit Hall
  • Track: Treatment in the Real World - Support, Survivorship, Systems Research
  • Presentations: 1
  • Now Available
  • Moderators:
  • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall

  • 31709

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    P2.16-26 - Opportunity of WBRT in EGFR-Mutated Lung Adenocarcinoma Patients with Multiple Brain Metastases: A Retrospective Study Based on DS-GPA (Now Available) (ID 1070)

    10:15 - 18:15  |  Author(s): Changhui Li
    • Abstract
    • Slides

    Background
    

    Whole-brain radiotherapy (WBRT) and epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are effective treatment options for multiple brain metastases (BM) in patients with EGFR-mutant adenocarcinoma. This study evaluated the optimal treatment sequence between EGFR-TKI and WBRT in patients with EGFR mutation adenocarcinoma and multiple BM

    Method
    

    A total of 195 patients with EGFR-mutant adenocarcinoma with multiple BM were enrolled in the study. Patients were treated with EGFR-TKI for over 4 weeks after WBRT,received EGFR-TKI concurrently in phase with WBRT or within 4 weeks after WBRTor treated with WBRT during intracranial progression after EGFR-TKI initiation. Overall survival (OS) and disease-specific Graded Prognostic Assessment (DS-GPA) was measured.

    Result
    

    For the entire cohort, the median OS was 27 months (95% CI, 24.6 to 29.4). GPA-based subdivided patients : upfront WBRT of GPA, 0 to 1.5 (median: 30 months; n=36; 18%); upfront WBRT of GPA, 2.0 to 3.5 (median:48 months; n=31; 16%); EGFR-TKI concurrently with WBRT of GPA, 0 to 1.5 (median:20 months; n=38; 19%); EGFR-TKI concurrently with WBRT of GPA 2.0 to 3.5 (median:37 months; n=26; 13%); upfront EGFR-TKI of GPA 0 to 1.5 (median:26 months; n=45; 23%); and upfront EGFR-TKI of GPA, 2.0 to 3.5 (median:17 months; n=19; 10%).The prognosis of patients in different GPA groups differed significantly (p<0.0001). The data by these parameters and the results showed no imbalance with respect to the number of patients on GPA scores ( T=1.786，p=0.076).In groups at EGFR-TKI concurrently with WBRT and upfront EGFR-TKI, patients with GPA score 2-3.5 demonstrated a significantly longer OS than those at score 0-1.5 (P=0.023) , patients with EGFR-TKI concurrently with WBRT is longer than those with upfront EGFR-TKI in subgroup at GPA score 2-3.5(P=0.023).There was no difference in the OS at 0-1.5 score level between the EGFR-TKI concurrently with WBRT group and the upfront EGFR-TKI group (P=0.141).

    Conclusion
    

    For EGFR-mutated lung adenocarcinoma patients with multiple BM,the use of upfront WBRT achieved a significantly longer OS in high DS-GPA scores groups.

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