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Y. Qiu
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P3.01 - Advanced NSCLC (ID 621)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P3.01-011 - Comparision of EGFR and ALK-Driven Lung Adenocarcinoma with Brain Metastases for Prognostic Factors in Chinese Patients (ID 8553)
09:30 - 09:30 | Author(s): Y. Qiu
- Abstract
Background:
Brain metastases are often seen in Eastern-Asian lung adenocarcinoma in which most common oncogenic driver mutations are EGFR sensitive mutations or EML4- ALK fusions, occurring in about 60% patients. Elucidation of EGFR and ALK-driven mutation prognostic factors in patients with brain metastases has important clinical implications.
Method:
Lung adenocarcinoma harboring EGFR mutations or ALK fusions were studied for their occurrence of brain metastases and relevant prognostic factors.
Result:
Of 602 lung patients with lung adenocarcinoma, 516 had EGFR mutations and 86 had EML4-ALK fusions. EGFR-mutation patients had much more brain metastases than ALK-fusion patients, whether at first diagnosis (40.1% vs 28%, P=0.03) or followed up two years (63.8% vs 42.7%, P＜0.01). Brain metastasis is a significant indicator for poor survival in the EGFR-mutation patients (P＜0.001), but not in the ALK-fusion patients (P=0.79). In the EGFR-mutation patients, late occurred brain metastases （after one year） predicted better survival (P=0.001). Meanwhile, female or young age was associated with better survival in the brain metastatic patients with ALK fusions (P＜0.05). Moreover, multivariate analysis indicated that tyrosine kinase inhibitor (TKI) treatment, no symptomatic brain metastases and cranial radiotherapy were the significant indicators for better survival in both EGFR-mutation and ALK-fusion patients (P＜0.05). Although there was no difference in overall survival between EGFR mutation and ALK fusion patients with brain metastases (P=0.23), in the TKI-treating subgroup ALK-fusion patients had longer survival time than EGFR-mutation patients(NR vs. 36 months, P=0.15). Furthermore, in the EGFR-mutation patients with brain metastases erlotinib was associated with better survival compared with gefitinib as first-line treatment (38 months vs 34 months, P=0.03)
Conclusion:
EGFR-mutation and ALK-fusion lung adenocarcinoma patients with brain metastases have distinct clinical characteristics and prognostic factors. However, while doing targeted treatment ALK-fusion indicated better survival than EGFR-mutation in the patients with brain metastases.
