EGFR-positive NSCLC and brain metastases: to operate or not?

  • Lee HH & al.
  • Sci Rep
  • 14 Nov 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with NSCLC with epidermal growth factor receptor (EGFR) mutations and brain metastases >1 cm who underwent brain surgery in addition to EGFR-tyrosine kinase inhibitors (TKIs) and radiotherapy (RT) had better outcomes than those who received TKIs and RT alone.

Why this matters

  • Studies suggest patients with NSCLC with an EGFR mutation have a greater risk for brain metastases.

Study design

  • 100 patients with EGFR-positive NSCLC and brain metastases underwent brain surgery plus TKI therapy and RT (n=40) or TKI and RT alone (n=60).
  • Median follow-up, 25.6 months.
  • Funding: Kaohsiung Medical University Hospital; others.

Key results

  • Mean survival was significantly better in the brain surgery group (21.9 vs 15.6 months; P=.026).
  • After multivariable analysis, brain surgery was not associated with better OS in the overall cohort (HR, 0.69; P=.134).
  • However, brain surgery significantly improved OS in patients with brain metastases >1 cm (aHR, 0.49; P=.008).

Limitations

  • Retrospective, single-center study.