Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases
Background Although the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) in EGFR‐mutant non‐small cell lung cancer (NSCLC) patients has been demonstrated, their efficacy in EGFR‐mutant NSCLCs with central nervous system (CNS) metastases and the role of rad...
| Main Authors: | , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-11-01
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| Series: | Thoracic Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/1759-7714.13189 |
| _version_ | 1819065195122655232 |
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| author | Yu Saida Satoshi Watanabe Tetsuya Abe Satoshi Shoji Koichiro Nozaki Kosuke Ichikawa Rie Kondo Kenichi Koyama Satoru Miura Hiroshi Tanaka Masaaki Okajima Masaki Terada Takashi Ishida Hiroki Tsukada Masato Makino Akira Iwashima Kazuhiro Sato Naoya Matsumoto Hirohisa Yoshizawa Toshiaki Kikuchi |
| author_facet | Yu Saida Satoshi Watanabe Tetsuya Abe Satoshi Shoji Koichiro Nozaki Kosuke Ichikawa Rie Kondo Kenichi Koyama Satoru Miura Hiroshi Tanaka Masaaki Okajima Masaki Terada Takashi Ishida Hiroki Tsukada Masato Makino Akira Iwashima Kazuhiro Sato Naoya Matsumoto Hirohisa Yoshizawa Toshiaki Kikuchi |
| author_sort | Yu Saida |
| collection | DOAJ |
| description | Background Although the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) in EGFR‐mutant non‐small cell lung cancer (NSCLC) patients has been demonstrated, their efficacy in EGFR‐mutant NSCLCs with central nervous system (CNS) metastases and the role of radiotherapy remain unclear. This study aimed to determine if it is preferable to add upfront cranial radiotherapy to EGFR‐TKIs in patients with EGFR‐mutant NSCLC with newly diagnosed brain metastases. Methods We retrospectively analyzed the data of EGFR‐mutant NSCLC patients with CNS metastases who received EGFR‐TKIs as a first‐line therapy. Results A total of 104 patients were enrolled and 39 patients received upfront brain radiotherapy, while 65 patients received first and second generation EGFR‐TKIs first. The median time to treatment failure (TTF) was 7.8 months (95% confidence interval [CI]: 6.3–9.4). The median survival time (MST) was 24.0 months (95% CI: 20.1–30.1). The overall response rate of the CNS was 37%. The median CNS progression‐free survival (PFS) was 13.2 months (95% CI: 10.0–16.2). Brain radiotherapy prior to EGFR‐TKI prolonged TTF (11.2 vs. 6.8 months, P = 0.038) and tended to prolong CNS‐PFS (15.6 vs. 11.1 months, P = 0.096) but was not significantly associated with overall survival (MST 26.1 vs. 24.0 months, P = 0.525). Univariate and multivariate analyses indicated that poor performance status and the presence of extracranial metastases were poor prognostic factors related to overall survival. Conclusion EGFR‐TKI showed a favorable effect for EGFR‐mutant NSCLC patients with CNS metastases. Prolonged TTF and CNS‐PFS were observed with upfront brain radiotherapy. |
| first_indexed | 2024-12-21T15:42:36Z |
| format | Article |
| id | doaj.art-4c3c0980a21a4b178a904cf7dd6b0608 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-12-21T15:42:36Z |
| publishDate | 2019-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-4c3c0980a21a4b178a904cf7dd6b06082022-12-21T18:58:27ZengWileyThoracic Cancer1759-77061759-77142019-11-0110112106211610.1111/1759-7714.13189Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastasesYu Saida0Satoshi Watanabe1Tetsuya Abe2Satoshi Shoji3Koichiro Nozaki4Kosuke Ichikawa5Rie Kondo6Kenichi Koyama7Satoru Miura8Hiroshi Tanaka9Masaaki Okajima10Masaki Terada11Takashi Ishida12Hiroki Tsukada13Masato Makino14Akira Iwashima15Kazuhiro Sato16Naoya Matsumoto17Hirohisa Yoshizawa18Toshiaki Kikuchi19Department of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Respiratory Medicine, Shinrakuen Hospital Niigata JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Internal Medicine, Niigata Cancer Center Hospital Niigata JapanDepartment of Internal Medicine, Niigata Cancer Center Hospital Niigata JapanDepartment of Internal Medicine, Niigata Cancer Center Hospital Niigata JapanDepartment of Respiratory Medicine, Saiseikai Niigata Hospital Niigata JapanDepartment of Respiratory Medicine, Saiseikai Niigata Hospital Niigata JapanDepartment of Respiratory Medicine, Niigata Prefectural Central Hospital Joetsu JapanDepartment of Respiratory Medicine, Niigata City General Hospital Niigata JapanDepartment of Respiratory Medicine, Shibata Hospital Shibata JapanDepartment of Respiratory Medicine, Nagaoka Chuo General Hospital Nagaoka JapanDepartment of Respiratory Medicine, Nagaoka Red Cross Hospital Nagaoka JapanDepartment of Respiratory Medicine, Nishi‐Niigata Chuo National Hospital Niigata JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanDepartment of Respiratory Medicine and Infectious Diseases Niigata University Graduate School of Medical and Dental Sciences Niigata JapanBackground Although the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) in EGFR‐mutant non‐small cell lung cancer (NSCLC) patients has been demonstrated, their efficacy in EGFR‐mutant NSCLCs with central nervous system (CNS) metastases and the role of radiotherapy remain unclear. This study aimed to determine if it is preferable to add upfront cranial radiotherapy to EGFR‐TKIs in patients with EGFR‐mutant NSCLC with newly diagnosed brain metastases. Methods We retrospectively analyzed the data of EGFR‐mutant NSCLC patients with CNS metastases who received EGFR‐TKIs as a first‐line therapy. Results A total of 104 patients were enrolled and 39 patients received upfront brain radiotherapy, while 65 patients received first and second generation EGFR‐TKIs first. The median time to treatment failure (TTF) was 7.8 months (95% confidence interval [CI]: 6.3–9.4). The median survival time (MST) was 24.0 months (95% CI: 20.1–30.1). The overall response rate of the CNS was 37%. The median CNS progression‐free survival (PFS) was 13.2 months (95% CI: 10.0–16.2). Brain radiotherapy prior to EGFR‐TKI prolonged TTF (11.2 vs. 6.8 months, P = 0.038) and tended to prolong CNS‐PFS (15.6 vs. 11.1 months, P = 0.096) but was not significantly associated with overall survival (MST 26.1 vs. 24.0 months, P = 0.525). Univariate and multivariate analyses indicated that poor performance status and the presence of extracranial metastases were poor prognostic factors related to overall survival. Conclusion EGFR‐TKI showed a favorable effect for EGFR‐mutant NSCLC patients with CNS metastases. Prolonged TTF and CNS‐PFS were observed with upfront brain radiotherapy.https://doi.org/10.1111/1759-7714.13189Brain metastasesEGFR mutationEGFR tyrosine kinase inhibitornon‐small cell lung cancerradiotherapy |
| spellingShingle | Yu Saida Satoshi Watanabe Tetsuya Abe Satoshi Shoji Koichiro Nozaki Kosuke Ichikawa Rie Kondo Kenichi Koyama Satoru Miura Hiroshi Tanaka Masaaki Okajima Masaki Terada Takashi Ishida Hiroki Tsukada Masato Makino Akira Iwashima Kazuhiro Sato Naoya Matsumoto Hirohisa Yoshizawa Toshiaki Kikuchi Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases Thoracic Cancer Brain metastases EGFR mutation EGFR tyrosine kinase inhibitor non‐small cell lung cancer radiotherapy |
| title | Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases |
| title_full | Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases |
| title_fullStr | Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases |
| title_full_unstemmed | Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases |
| title_short | Efficacy of EGFR‐TKIs with or without upfront brain radiotherapy for EGFR‐mutant NSCLC patients with central nervous system metastases |
| title_sort | efficacy of egfr tkis with or without upfront brain radiotherapy for egfr mutant nsclc patients with central nervous system metastases |
| topic | Brain metastases EGFR mutation EGFR tyrosine kinase inhibitor non‐small cell lung cancer radiotherapy |
| url | https://doi.org/10.1111/1759-7714.13189 |
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