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Real‐world utilization of EGFR TKIs and prognostic factors for survival in EGFR‐mutated non‐small cell lung cancer patients with brain metastases

International Journal of Cancer May 16, 2021

Yu X, Sheng J, Pan G, et al. - Researchers sought to determine the effect of different treatments among patients suffering from epidermal growth factor receptor (EGFR)‐mutated non‐small cell lung cancer (NSCLC). They enrolled in this study 571 patients with EGFR‐mutated NSCLC and brain metastasis (BM). Participants had received EGFR tyrosine kinase inhibitors (TKIs). Median survival post-BM was 21.3 months. Significantly superior survival post-resistance to front‐line TKIs was conferred by osimertinib; the median overall survival (OS) reached 28.0 months, and the T790M status demonstrated no difference in clinical effectiveness. A longer OS was associated with the combination of TKIs and chemotherapy/vascular endothelial growth factor (VEGF) inhibitors (anti‐VEGF). Identified independent pretreatment prognostic factors, in multivariable analysis, included age, Karnofsky performance score, EGFR mutation type, number of BMs and the presence of extracranial metastasis. Overall, findings showed a significant impact of EGFR TKIs on patients with EGFR‐mutant BM, and further improvement in survival outcomes irrespective of T790M status was conferred by osimertinib use. A survival benefit can be experienced by patients who receive intracranial local therapy.

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