Author of

• 18975

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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)

  • 23925

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    P3.01-066 - CNS Metastases of Pulmonary Adenocarcinoma Harboring EGFR-Activating Mutations: a Multidisciplinary Approach, Including EGFR-TKis (ID 10395)

    09:30 - 09:30  |  Author(s): G. De Castro Jr
    • Abstract

    Background:
    The incidence of CNS metastases among patients (pts) with pulmonary adenocarcinoma harboring EGFR-activating mutations seems to be increasing, probably related to their prolonged overall survival. A multidisciplinary approach, including radiation therapy, surgery and EGFR-TKIs, is absolutely essential for the management of these pts. We aimed to study the effectiveness of this multidisciplinary approach of CNS metastases in pts not previously treated with EGFR-TKis.
    
    Method:
    It is a retrospective, uni-institutional study, and all pts were consecutively identified and treated between 2009 and 2017. Eligible pts had to be diagnosed with pulmonary adenocarcinoma harboring EGFR-activating mutations (Sanger sequencing performed in either archived, or new, formalin-fixed and paraffin-embedded samples). CNS involvement was diagnosed based on CT scans, MRI and/or cerebrospinal fluid findings. All studied pts were treated with EGFR-TKIs (erlotinib or gefitinib) and other multimodality therapies including radiation therapy (whole brain or stereotactic radiosurgery), metastasectomy and/or intrathecal methotrexate, based on the decision of the multidisciplinary team.
    
    Result:
    35 pts were studied, with a median age 63 y.o. (35-90), being 26 (74%) female, 19 (54%) never-smokers, and 26 (74%) ECOG-PS 0-2. All pts received an EGFR-TKI (erlotinib or gefitinib), and 26 also were treated with radiation therapy, 11 were submitted to surgery, 2 to stereotactic radiosurgery and 1 received IT-MTX; 4/35 were treated with an EGFR-TKI only. Median treatment time with an EGFR-TKI was 7.6 mo. Median progression-free survival (mPFS) was 8.2 mo and the median overall survival (mOS) was 11.9 mo. Among those 25 pts whose tumors were diagnosed with an exon 19 deletion, mPFS was 8.2 mo. and mOS 11.9 mo., and among those 9 pts with L858R mutation, mPFS was 10.8 mo. and mOS 13.8 mo.
    
    Conclusion:
    Those pts diagnosed with pulmonary adenocarcinoma harboring EGFR-activating mutations treated with a multidisciplinary approach (including an EGFR-TKI) may derive promising PFS and OS results. The approach must be individualized, considering patient characteristics, tumor biology aspects and also the available healthcare resources.