175P Incidence and treatment outcomes of brain metastasis in advanced non-small cell lung cancer at presentation: An experience from south India

Abstract

Background: Brain metastasis is one of the significant problems in patients with lung cancer. Most of the patients are asymptomatic at presentation. Prognosis and survival in these patients are lacking. Many studies that looked upon the incidence of brain metastasis at the presentation of NSCLC are retrospective. In India, brain metastasis frequency in patients with NSCLC at the presentation has not been well studied. This study has been planned to evaluate the incidence of brain metastasis in NSCLC patients treated in our center. Methods: It is a prospective observational study conducted in medical oncology at our tertiary care center from Sep 2019- Sep 2020. A total of 150 patients with lung cancer were registered in the department. Among them, 112 patients had advanced non-small cell carcinoma of the lung (NSCLC), and they were enrolled in the study. MRI brain was taken at the time of diagnosis. Results: The mean age at presentation was 60 years. The Median follow-up was 15 months. Median overall survival in the study was 11 months. Patients with brain metastasis had a median survival of 7 months, whereas patients without brain metastasis had 13 months. Clinical profile, performance status, demographic characteristics, and imaging findings were noted at the presentation time and the results were analyzed as follows. Table 175PBaseline characteristicsNo of Patients (%)Mean age60 years<6044 (39%)>6068 (61%)SexMale69 (62%)Female43 (38%)Adenocarcinoma86 (77%)Squamous cell carcinoma26 (23%)Brain metastasis39 (35%)Male19 (49%)Female20 (51%)Adenocarcinoma32 (82%)Squamous cell carcinoma7 (18%)Asymptomatic12 (30%)Symptomatic27 (70%)Synchronous metastasis21 (19%)Contralateral lung metastasis12 (57%)Bone metastasis5 (23%) Open table in a new tab Conclusions: The study period is short, so that data on molecular abnormalities in patients with brain metastasis was not included in the data. Our study found that female patients were at higher risk for brain metastasis. Other risk factors were adenocarcinoma histology and age less than 60 years. There are no biomarkers to predict brain metastasis in NSCLC due to its molecular heterogeneity. The study will serve as a baseline platform of clinical predictors of brain metastasis in NSCLC. Our future direction and research will be clinical predictors along with molecular driver mutations in NSCLC in detecting brain metastasis. Legal entity responsible for the study: Rajiv Gandhi Government General Hospital, Madras Medical College. Funding: Has not received any funding. Disclosure: The author has declared no conflicts of interest.