Impact of EGFR and ALK mutation on the outcomes of non-small cell lung cancer (NSCLC) patients with brain metastases.

Abstract

2005Background: Brain metastases (BM) are common serious complication of NSCLC. Activating mutations in EGFR and ALK constitute 10-15% and 5% of NSCLC respectively. Patients with multiple BM (≥4) have inferior outcomes compared to single or limited BM (≤ 3) in wild type NSCLC. There is limited information on impact of number of BM on EGFR and ALK positive NSCLC BM. Methods: With IRB approval, the Cleveland Clinic Neuro-Oncology Center’s database was used to identify patients treated between 2000-2014 for Non-Small Cell Lung Cancer (NSCLC) BM with mutational status (EGFR/ALK/wild). Overall survival (OS) from the diagnosis of BM was the primary end point. Cox proportional hazards models were used for data analysis. Results: 1032 NSCLC patients with BM were included in the analysis. Among 322 NSCLC BM with mutational analysis, 88 were positive for mutation (ALK = 21; EGFR = 67) and 234 were wild type. Median age at diagnosis in EGFR, ALK + NSCLC BM was 59.5 (range 29.8, 82.6) and 50.6% (43 patients) had KPS ...