Denis Moro-Sibilot1, Egbert Smit2, Javier de Castro Carpeño3, Krzysztof Lesniewski-Kmak4, Joachim G Aerts5, Rosa Villatoro6, Kees Kraaij7, Karim Nacerddine8, Yulia Dyachkova9, Karen T Smith10, Allicia Girvan10, Carla Visseren-Grul7, Philipp A Schnabel11. 1. Unité d'Oncologie Thoracique-Pneumologie, CHU de Grenoble, INSERM U823, Grenoble, France. Electronic address: DMoro-Sibilot@chu-grenoble.fr. 2. Vrije Universiteit Medical Centre, Amsterdam, The Netherlands. 3. Hospital Universitario La Paz, Madrid, Spain. 4. Medical University of Gdańsk, Gdynia, Poland. 5. Amphia Hospital Breda, Rotterdam, The Netherlands; Erasmus MC, Rotterdam, The Netherlands. 6. Hospital Costa del Sol, Marbella, Spain. 7. Eli Lilly and Company, Houten, The Netherlands. 8. Eli Lilly and Company, Neuilly-sur-Seine, France. 9. Eli Lilly GmbH, Vienna, Austria. 10. Eli Lilly and Company, Indianapolis, IN, USA. 11. Institut für Allgemeine und Spezielle Pathologie, Universitätsklinikum des Saarlandes, Homburg, Saarland, Germany.
Abstract
OBJECTIVES: We report on a post-hoc analysis of patients with brain metastases from a large prospective observational study of first-line treatment of non-small cell lung cancer (NSCLC). The aim was to describe baseline characteristics of NSCLC patients with brain metastases, understand their first-line treatment and report outcomes attained in real-world settings. MATERIALS AND METHODS: This post-hoc analysis included all patients in the European observational FRAME study who had brain metastases at initiation of first-line treatment. Descriptive statistics were used for continuous and categorical variables and survival outcomes were assessed using the Kaplan-Meier approach. RESULTS: Our data showed that 17% of patients (263/1564) had spread of the disease to the brain at initiation of first-line treatment. Patients with brain metastases were slightly younger, and more likely to have NSCLC of non-squamous histology than the overall study sample. 34% had received prior palliative radiotherapy to the brain. Our analysis showed a median overall survival (OS) of 7.2 months [95% confidence interval (CI) 6.1-8.2] for all patients with brain metastases treated with first-line platinum-based chemotherapy, ranging from 5.6 months for those treated with gemcitabine plus platinum up to 9.3 months for those treated with pemetrexed plus platinum. Further analysis showed that patients with brain metastases were more frequently treated with pemetrexed platinum-doublet therapy than with any other regimen. CONCLUSIONS: Our analysis provides a unique set of real-world data which adds to current understanding about treatment decisions and outcomes for NSCLC patients with brain metastases for whom there is little clinical trial data available.
OBJECTIVES: We report on a post-hoc analysis of patients with brain metastases from a large prospective observational study of first-line treatment of non-small cell lung cancer (NSCLC). The aim was to describe baseline characteristics of NSCLCpatients with brain metastases, understand their first-line treatment and report outcomes attained in real-world settings. MATERIALS AND METHODS: This post-hoc analysis included all patients in the European observational FRAME study who had brain metastases at initiation of first-line treatment. Descriptive statistics were used for continuous and categorical variables and survival outcomes were assessed using the Kaplan-Meier approach. RESULTS: Our data showed that 17% of patients (263/1564) had spread of the disease to the brain at initiation of first-line treatment. Patients with brain metastases were slightly younger, and more likely to have NSCLC of non-squamous histology than the overall study sample. 34% had received prior palliative radiotherapy to the brain. Our analysis showed a median overall survival (OS) of 7.2 months [95% confidence interval (CI) 6.1-8.2] for all patients with brain metastases treated with first-line platinum-based chemotherapy, ranging from 5.6 months for those treated with gemcitabine plus platinum up to 9.3 months for those treated with pemetrexed plus platinum. Further analysis showed that patients with brain metastases were more frequently treated with pemetrexedplatinum-doublet therapy than with any other regimen. CONCLUSIONS: Our analysis provides a unique set of real-world data which adds to current understanding about treatment decisions and outcomes for NSCLCpatients with brain metastases for whom there is little clinical trial data available.
Authors: Thiago Pimentel Muniz; Victor Hugo Fonseca de Jesus; Victor Aurélio Ramos Sousa; Malu Viter da Rosa Barbosa; Vladmir Cláudio Cordeiro de Lima Journal: J Thorac Dis Date: 2019-09 Impact factor: 2.895