P2.03b-020 EGFR Exon 19 Deletion Mutation Patients Obtain Optimal Survival in Icotinib Treated Non–Small-Cell Lung Cancer Patient with Brain Metastases: Topic: Brain Meta

Abstract

Lung cancer is characterized by the highest incidence of solid tumor-related brain metastases. This is also one of the reasons why it can cause significant mortality. Molecular targeted therapy plays a major role in the management of brain metastases in lung cancer, which has become the novel methods for treatment of lung cancer with brain metastases. Our study aims to explore the efficacy of the EGFR targeted treatments in NSCLC brain metastases, specially according to EGFR mutation sub-types. We collected 116 patients with NSCLC brain metastases who underwent EGFR-TKIs therapy from 2011-2015 of Zhejiang cancer hospital. The data were analyzed to get progression-free survival for intracranial disease (MPFSI)、median progression-free survival for extracranial disease (MPFSE)、median overall median progression-free survival (MPFS)、median overall survival (MOS), which were evaluated by Kaplan-Meier and multivariate analysis were performed by Cox model. The overall response rate for 116 patients with Icotinib treatment was 61%. No increase in neurotoxicity was detected. The overall response rate was significant higher with EGFR exon 19 deletion mutation than with EGFR exon 21 mutation, other type EGFR mutations or EGFR-wild type (68% VS 42%). MPFSI, MPFSE and MOS was also significantly longer with EGFR exon 19 deletion mutation than with EGFR exon 21 mutation, other type EGFR mutations or EGFR-wild type (P<0.05). Icotinib was well tolerated with a favorable objective response. In sub-group analysis, the NSCLC with brain metastases patients with EGFR exon 19 deletion mutation obtain better survival than those patients with EGFR exon 21 mutation, other type EGFR mutations or EGFR-wild type.