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Brain metastases in Japanese NSCLC patients: prognostic assessment and the use of osimertinib and immune checkpoint inhibitors-retrospective study.
Higaki, Hajime; Nishioka, Kentaro; Otsuka, Manami; Nishikawa, Noboru; Shido, Motoyasu; Minatogawa, Hideki; Nishikawa, Yukiko; Takashina, Rikiya; Hashimoto, Takayuki; Katoh, Norio; Taguchi, Hiroshi; Kinoshita, Rumiko; Yasuda, Koichi; Mori, Takashi; Uchinami, Yusuke; Koizumi, Fuki; Fujita, Yoshihiro; Takahashi, Shuhei; Hattori, Takahiro; Nishiyama, Noriaki; Aoyama, Hidefumi.
Affiliation
  • Higaki H; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Nishioka K; Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
  • Otsuka M; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Nishikawa N; Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan.
  • Shido M; Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
  • Minatogawa H; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Nishikawa Y; Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan.
  • Takashina R; Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan.
  • Hashimoto T; Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan.
  • Katoh N; Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
  • Taguchi H; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Kinoshita R; Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
  • Yasuda K; Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
  • Mori T; Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
  • Uchinami Y; Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
  • Koizumi F; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Fujita Y; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Takahashi S; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Hattori T; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Nishiyama N; Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
  • Aoyama H; Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan.
Radiat Oncol ; 18(1): 25, 2023 Feb 07.
Article in En | MEDLINE | ID: mdl-36750899
ABSTRACT

BACKGROUND:

The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA) has not been validated for use with Japanese non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) and the factors impacting survival need to be assessed.

METHODS:

We retrospectively analyzed 294 NSCLC patients who were newly diagnosed with BM between 2013 and 2020 and had received radiotherapy for BM initially at the Hokkaido Cancer Center. We evaluated the effect on the prognosis of Lung-molGPA items, the expression of PD-L1 (classified as high, low, and no expression), and the treatment history. The main outcome was the survival measured from the day of the diagnosis of BM, and log-rank tests were performed to evaluate the results.

RESULTS:

The median overall survival (OS) times for adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, 2.5‒3.0, and 3.5‒4.0) were 5.5, 14.8, 28.3, and 39.0 months (p < 0.0001), respectively. The median survival times for non-adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, and 2.5‒3.0) were 3.2, 11.0, and 16.0 months (p = 0.0011), respectively. In adenocarcinoma patients with gene mutations, osimertinib significantly improved the outcome (median OS 34.2 and 17.6 months with and without osimertinib, respectively (p = 0.0164)). There was no significant difference in the OS between patients who were initially treated with tyrosine-kinase inhibitor for BM and those who initially received radiotherapy (p = 0.5337). In patients tested for PD-L1 expression, the median survival times after the diagnosis of BM were 5.6, 22.5, and 9.3 months for the high-, low- and no-expression groups (p = 0.2198), respectively. Also, in patients with high PD-L1 expressions, those with ICI had survival (median OS, 8.6 months) than those without (median OS, 3.6 months).

CONCLUSIONS:

We confirmed that Lung-molGPA successfully classified Japanese NSCLC patients with BM by the prognosis. Osimertinib prolonged survival of EGFR-positive NSCLC patients with BM, and ICI was effective in patients with high PD-L1 expressions.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Brain Neoplasms / Adenocarcinoma / Carcinoma, Non-Small-Cell Lung / Lung Neoplasms Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Radiat Oncol Journal subject: NEOPLASIAS / RADIOTERAPIA Year: 2023 Document type: Article Affiliation country: Japan

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Brain Neoplasms / Adenocarcinoma / Carcinoma, Non-Small-Cell Lung / Lung Neoplasms Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Language: En Journal: Radiat Oncol Journal subject: NEOPLASIAS / RADIOTERAPIA Year: 2023 Document type: Article Affiliation country: Japan