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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Wednesday, September 11, 2024
Select molecular mutations may influence clinical outcomes for patients with non–small cell lung cancer (NSCLC) who have brain metastases. In fact, EGFR and ALK mutations were associated with a better prognosis in these patients. The findings of this retrospective study were presented by Xiaoyan Li, MD, of Beijing Tian Tan Hospital, Fengtai District, China, and a colleague at the 2024 American Society of Clinical Oncology (ASCO) Breakthrough conference (Abstract 201).
“Advances in gene-directed therapies have shifted the focus away from traditional platinum-based chemotherapies. This study highlights the importance of molecular mutations in NSCLC brain metastases as prognostic indicators and therapeutic targets,” stated the investigators.
A total of 1,526 patients with NSCLC and brain metastases were treated over the course of 12 years (2010–2022) at two hospitals in Beijing. Collected data from these patients included information regarding molecular marker status, systemic therapies, and dates of disease progression. A Cox proportional hazards model was used to identify associations between mutational status and median overall or progression-free survival from the time of diagnosis of brain metastasis to the final follow-up or death.
The most significant alterations found in records from patients with NSCLC and brain metastases were from mutations in EGFR (n = 628) and BRAF mutations (n = 31) as well as rearrangements in ALK (n = 207) and ROS1 (n = 64). MET skipping was observed in 55 patients, as well as RET fusions in 42 patients.
Overall, patients with the highest median overall survival and progression-free survival were those with EGFR and ALK mutations. Additionally, patients with RET and ROS1 mutations had better survival outcomes than did those with BRAF and MET mutations.
Disclosure: The study authors reported no conflicts of interest.
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