Dae-Won Lee1, Dong-Yeop Shin2, Jin Wook Kim3, Bhumsuk Keam4, Tae Min Kim4, Hak Jae Kim5, Dong-Wan Kim4, Hong-Gyun Wu5, Sun Ha Paek3, Young Whan Kim1, Dae Seog Heo4, Dong Gyu Kim3, Se-Hoon Lee6. 1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. 2. Department of Internal Medicine, Korea Cancer Center Hospital, Seoul, Korea. 3. Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea. 4. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. 5. Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea. 6. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. Electronic address: shlee119@snu.ac.kr.
Abstract
OBJECTIVE: While several prognostic models have been presented in NSCLC patients with brain metastasis, none of these models have included molecular markers as an index. The aim of our study was to evaluate the prognostic value of EGFR mutations and to integrate these EGFR mutations into the prognostic index in NSCLC patients with brain metastasis. MATERIALS AND METHODS: We analyzed retrospectively 292 lung adenocarcinoma patients with brain metastasis. Clinico-pathological features and overall survival (OS) were compared between patients with EGFR mutations and patients with EGFR wild type. EGFR mutation status was integrated with lung specific graded prognostic assessment (GPA) score. RESULTS: Among 292 patients, EGFR mutation status was tested in 183 patients. One hundred and five patients (57.4%) had EGFR activating mutations, 14 (7.7%) had EGFR non-activating mutations and 64 (35.0%) had EGFR wild type. OS was significantly longer in patients with EGFR activating mutations than in those with EGFR wild type patients (20.4 vs. 10.1 months, p = 0.002). However, patients with EGFR non-activating mutations did not show superior OS compared with EGFR wild type patients (14.6 vs. 10.1 months, p = 0.83). Multivariate analysis revealed that the presence of EGFR activating mutation is an independent positive prognostic factor for OS (adjusted hazard ratio 0.56, p = 0.002). CONCLUSIONS: EGFR activating mutations have a prognostic role in lung adenocarcinoma patients with brain metastasis that is independent of other known prognostic factors. The frequency of EGFR mutation was higher than expected. The presence of EGFR activating mutations should be included as an index in the prognostic models for lung adenocarcinoma patients with brain metastasis.
OBJECTIVE: While several prognostic models have been presented in NSCLCpatients with brain metastasis, none of these models have included molecular markers as an index. The aim of our study was to evaluate the prognostic value of EGFR mutations and to integrate these EGFR mutations into the prognostic index in NSCLCpatients with brain metastasis. MATERIALS AND METHODS: We analyzed retrospectively 292 lung adenocarcinomapatients with brain metastasis. Clinico-pathological features and overall survival (OS) were compared between patients with EGFR mutations and patients with EGFR wild type. EGFR mutation status was integrated with lung specific graded prognostic assessment (GPA) score. RESULTS: Among 292 patients, EGFR mutation status was tested in 183 patients. One hundred and five patients (57.4%) had EGFR activating mutations, 14 (7.7%) had EGFR non-activating mutations and 64 (35.0%) had EGFR wild type. OS was significantly longer in patients with EGFR activating mutations than in those with EGFR wild type patients (20.4 vs. 10.1 months, p = 0.002). However, patients with EGFR non-activating mutations did not show superior OS compared with EGFR wild type patients (14.6 vs. 10.1 months, p = 0.83). Multivariate analysis revealed that the presence of EGFR activating mutation is an independent positive prognostic factor for OS (adjusted hazard ratio 0.56, p = 0.002). CONCLUSIONS:EGFR activating mutations have a prognostic role in lung adenocarcinomapatients with brain metastasis that is independent of other known prognostic factors. The frequency of EGFR mutation was higher than expected. The presence of EGFR activating mutations should be included as an index in the prognostic models for lung adenocarcinomapatients with brain metastasis.
Authors: Yuhao Huang; Kevin K H Chow; Jacqueline V Aredo; Sukhmani K Padda; Summer S Han; Bina W Kakusa; Melanie Hayden Gephart Journal: World Neurosurg Date: 2019-01-31 Impact factor: 2.210
Authors: D Révész; E G Engelhardt; J J Tamminga; F M N H Schramel; B D Onwuteaka-Philipsen; E M W van de Garde; E W Steyerberg; E P Jansma; H C W De Vet; V M H Coupé Journal: BMC Med Inform Decis Mak Date: 2017-10-02 Impact factor: 2.796