Abstract
Patients with EGFR mutation may have prolonged OS after diagnosis of brain metastases independent of treatment strategy. Tumor harbouring EGFR mutation with brain metastases from NSCLC is around 10-53%, seems to be more frequent in women, never-smokers, East Asians patients and in adenocarcinomas. To explore the EGFR mutations status and EML4-ALK fusions in patients with NSCLC and brain metastases and the overall survival. To evaluate whether age ≥60 years, gender, KPS ≥70, EGFR mutation, smoking status, impacted in overall survival. Between January 2008 and January 2014 we retrospectively identified 42 patients with NSCLC brain metastases who had done EGFR test. Overall survival was analyzed by Kaplan-Meier method, with the use of two-sided log-rank test statistics. Median age: 58 years (35-81). Nineteen were female. Median follow up: 9 months (1-74). Thirty six of 42 patients (86%) were current or former smokers. All never smokers patients and only 3 of 36 (8%) current or former smokers had EGFR mutation. Of the 42 patients 9 (21,5%) harboured mutation in the EGFR gene and only one was male. Only 2 patients of 31 evaluated (6,4%) had EML4-ALK fusion. The median overall survival in patients with EGFR mutation and EGFR wild type was 17 (5-100) and 11 months (1-96) respectively (p:0.46). After brain metastases the median overall survival in patients with EGFR mutation and EGFR wild type was 13 (5-74) and 9 months (1-61) respectively (p:0.95). Patients with metachronous brain metastases had better survival (p:0,004). Only KPS did show statistically significant impact benefit on survival (p:0.026) and survival after brain metastases (p:0.03). Twenty one percent of the patients with brain metastases harboured EGFR mutation, the median overall survival was better that we expected (13 months) although the difference was not significant.
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