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J. Kim



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    P2.11 - Poster Session 2 - NSCLC Novel Therapies (ID 209)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.11-037 - EGFR Activating Mutation and Bone Metastasis Have Association With CNS Metastasis at Diagnosis in Patients with Non-small Cell Lung Cancer (ID 2713)

      09:30 - 09:30  |  Author(s): J. Kim

      • Abstract

      Background
      CNS metastasis happens not infrequently in patients with non-small cell lung cancer, reaching upto 25%. The presence of CNS metastasis is a major decision factor of planning primary treatment. Furthermore, predictors for CNS metastasis could be used for selecting patients who may get the potential benefit of prophylactic cranial irradiation.

      Methods
      We retrospectively analyzed the clinicopathologic data of 233 patients with non-small cell lung cancer who underwent brain MRI at the time of diagnosis between Jan 2008 and Dec 2012. Chi-square analysis and multivariate logistic regression model was used to find risk factors for CNS metastasis.

      Results
      Forty-five (19.3%) patients had initial CNS metastasis (41 brain parenchymal metastasis and 4 leptomeningeal seeding). Chi-square analysis revealed that never-smoking (28.7% vs. 13.7%, P=0.005), lung metastasis (29.6% vs 14.8%, P=0.009), bone metastasis (35.7% vs 13.1%, P<0.001), adenocarcinoma (24.8% vs 10.9%, P=0.008), and EGFR activating mutation (44.4% vs 18.3%, P=0.004) were associated with CNS metastasis. However, pleural, pericardial, adrenal, liver metastasis, gender, age, and T/N staging did not have correlation with CNS metastasis. Multivariate analysis indicated that only EGFR activating mutation status (adjusted HR, 4.3; 95% CI, 1.6-11.2; P=0.003) and bone metastasis (adjusted HR, 4.0; 95% CI, 1.5-10.6; P=0.005) had independent association with CNS metastasis.

      Conclusion
      In the current study, EGFR activating mutation status and presence of bone metastasis are independently associated with initial CNS metastasis. Initial staging work-up for patients with these clinicopathologic features should include brain MRI. Results of this study can be used for selecting candidates for prophylactic cranial eradiation or adjuvant EGFR tyrosine kinase inhibitor treatment.