Add-on WBRT extends survival with NSCLC brain metastases

  • Chen CH & al.
  • Cancers (Basel)
  • 31 Jul 2019

  • curated by Craig Hicks
  • Univadis Clinical Summaries
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Takeaway

  • Adding whole-brain radiotherapy (WBRT) to anti-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) significantly prolongs survival in patients with EGFR+ NSCLC brain metastases.

Why this matters

  • As treatments advance and survival improves, emerging concerns for neurocognitive toxicity have stoked debate regarding the role of WBRT in treating NSCLC brain metastases.

Study design

  • Study of 141 patients with EGFR+ NSCLC-related brain metastases receiving EGFR-TKIs; 94 (66.7%) also underwent WBRT.
  • Median follow-up was 20.3 months.
  • Funding: Kaohsiung Medical University Hospital; Ministry of Science and Technology, Taiwan.

Key results

  • 1-year OS rate was greater with TKI+WBRT (81.9%) vs TKI alone (81.9% vs 59.6%; P=.002).
  • Median OS after brain metastasis diagnosis:
    • 14.3 (95% CI, 9.5-18.3) months for TKI+WBRT, and
    • 2.3 (95% CI, 2-2.6) months for TKI alone.

Limitations

  • Retrospective, monocentric design.
  • OS endpoint may not correlate with tumor response.

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