Clinical and molecular characteristics of patients with brain metastasis secondary to pancreatic ductal adenocarcinoma.
Oncologist
; 2024 Jul 16.
Article
em En
| MEDLINE
| ID: mdl-39014543
ABSTRACT
BACKGROUND:
The prognosis for patients with pancreatic ductal adenocarcinoma (PDAC) is poor. Secondary brain metastasis (Br-M) occurs in less than 1% of patients. Clinical characteristics and molecular alterations have not been characterized in this rare patients' subset. MATERIALS ANDMETHODS:
The Foundry software platform was used to retrospectively query electronic health records for patients with Br-M secondary to PDAC from 2005 to 2023; clinical, molecular, and overall survival (OS) data were analyzed.RESULTS:
Br-M was diagnosed in 44 patients with PDAC. Median follow-up was 78 months; median OS from initial PDAC diagnosis was 47 months. Median duration from PDAC diagnosis to Br-M detection was 24 months; median OS from Br-M diagnosis was 3 months. At Br-M diagnosis, 82% (nâ =â 36) of patients had elevated CA19-9. Lung was the most common preexisting metastatic location (71%) with Br-M, followed by liver (66%). Br-M were most frequently observed in the frontal lobe (34%, nâ =â 15), cerebellar region (23%, nâ =â 10), and leptomeninges (18%, nâ =â 8). KRAS mutations were detected in 94.1% (nâ =â 16) of patients who had molecular data available (nâ =â 17) with KRASG12V being the most frequent subtype 47% (nâ =â 8); KRASG12D in 29% (nâ =â 5); KRASG12R in 18% (nâ =â 3). Patients who underwent Br-M surgical resection (nâ =â 5) had median OS of 8.6 months, while median OS following stereotactic radiosurgery only (nâ =â 11) or whole-brain radiation only (nâ =â 20) was 3.3 and 2.8 months, respectively.CONCLUSION:
Br-M is a late PDAC complication, resulting in an extremely poor prognosis especially in leptomeningeal disease. KRAS was mutated in 94.1% of the patients and the KRASG12V subtype was prevalent.
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article