title: The Importance of Brain Metastasis in EGFR Mutation Positive NSCLC Patients.
abstract: Introduction. Brain metastasis is a poor prognostic marker in lung cancer. However it is not known whether amongst patients with EGFR mutation those with brain metastases have a worse outcome. Methods. We compared the survival outcomes between EGFR mutation positive patients with and without brain metastases. In this retrospective analysis of prospective database of all metastatic lung cancer patients at our centre between July 2009 and December 2012, patients were treated with either combination chemotherapy or oral TKI. All patients with brain metastases received whole brain radiation. Kaplan Meier method was used for survival analysis and compared using log rank test. Results. 101 patients with EGFR mutated, metastatic lung cancer were studied. Fourteen had brain metastases and 87 did not. The common EGFR mutations were exon 19 deletion (61.3%) and exon 21 L858R mutation (28.7%). Overall response was 64% in extracranial metastasis group as compared to 50% in brain metastasis group. There was a significant worsening of median OS in the patients with brain metastases (11.6 months) compared with only extracranial metastases (18.7 months), P = 0.029. Conclusion. Amongst patients with EGFR mutant NSCLC, the presence of brain metastases leads to a worse outcome as compared to patients with extracranial metastases alone.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Vanita
authors.initials: V
authors.lastname: Noronha
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Joshi
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Anant
authors.initials: A
authors.lastname: Gokarn
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Vibhor
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Medical Oncology, Malabar Cancer Center, Moozhikkara, Kannur, Kerala 670103, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Patil
authors.affiliation: Department of Radiodiagnosis, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Janu
authors.affiliation: Department of Nuclear Medicine, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Nilendu
authors.initials: N
authors.lastname: Purandare
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Anuradha
authors.initials: A
authors.lastname: Chougule
authors.affiliation: Department of Pathology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Nirmala
authors.initials: N
authors.lastname: Jambhekar
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai, Maharashtra 400012, India.
authors.forename: Kumar
authors.initials: K
authors.lastname: Prabhash