Prognostic impact of EGFR/ALK alterations in leptomeningeal metastasis from lung adenocarcinoma treated with whole-brain radiotherapy

AbstractThe prognosis and prognostic factors of patients receiving whole-brain radiotherapy (WBRT) for leptomeningeal metastasis (LM) from lung adenocarcinoma have not been established. Particularly, the impact ofEGFR mutations andALK rearrangements on survival remains unclear. This retrospective study evaluated the prognosis and prognostic factors of patients receiving WBRT for LM. We evaluated overall survival (OS) from WBRT initiation and clinical variables in 80 consecutive patients receiving WBRT for LM from lung adenocarcinoma at our institution between June 2013 and June 2021. After a median follow-up of 5.2 (range 0.5 –56.5) months, the median OS was 6.2 months (95% CI 4.4–12.4). Of the 80 patients, 51 were classified asEGFR/ALK mutant (EGFR: 44;ALK: 6; both: 1) and 29 as wild-type. The median OS was 10.4 (95% CI 5.9 –20.9) versus 3.8 (95% CI 2.5–7.7) months in theEGFR/ALK-mutant versus wild-type patients (HR  = 0.49,P = 0.0063). Multivariate analysis indicated thatEGFR/ALK alterations (HR  = 0.54,P = 0.021) and Eastern Cooperative Oncology Group performance status (ECOG PS) of 0–1 (HR = 0.25,P <  0.001) were independent factors associated with favorable OS. Among the patients who underwent brain MRI before and after WBRT, intracranial progression-free survival was longer in the 26EGFR/ALK-mutant than 13 wild-type patients (HR  = 0.31,P = 0.0039). Although the prognosis of patients receiving WBRT for LM remains poor,EGFR/A...
Source: Clinical and Experimental Metastasis - Category: Cancer & Oncology Source Type: research