Evidence map›Paper›PMID 25910841›Full record

ArticleNeuro-oncology2015

Does lung cancer mutation status and targeted therapy predict for outcomes and local control in the setting of brain metastases treated with radiation?

Tony J C Wang, Shumaila Saad, Yasir H Qureshi, Ashish Jani, Tavish Nanda, Andrew M Yaeh, Tzlil Rozenblat, Michael B Sisti, Jeffrey N Bruce, Guy M McKhann and 6 more

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Article in Neuro-oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
5.0field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 4 institutions in 1 country.

Tony J C WangDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Shumaila SaadDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Yasir H QureshiDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Ashish JaniDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Tavish NandaDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Andrew M YaehDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Tzlil RozenblatDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Michael B SistiDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Jeffrey N BruceDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Guy M McKhannDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Jeraldine LesserDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Balazs HalmosDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Mark B StooplerDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Andrew B LassmanDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Simon K ChengDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Steven R IsaacsonDepartment of Radiation Oncology (T.J.C.W., S.S., A.J., T.N., A.M.Y., T.R., J.L., S.K.C., S.R.I.); Herbert Irving Comprehensive Cancer Center (T.J.C.W., M.B.Si., J.N.B., G.M.M., B.H., M.B.St., A.B.L., S.K.C., S.R.I.); The Taub Institute for Research on Alzheimer's Disease and the Aging Brain (Y.H.Q.); Department of Neurological Surgery (M.B.Si., J.N.B., G.M.M.); Department of Neurology (A.B.L.); and Division of Hematology/Oncology (B.H., M.B.St.), Columbia University Medical Center, New York, New York.
Sylvester Comprehensive Cancer Center · USHerbert Irving Comprehensive Cancer CenterColumbia University Irving Medical Center · USNeurological Surgery · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe investigated effects of genetic alterations in epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and Kirsten rat sarcoma viral oncogene homolog (KRAS) on overall survival (OS) and local control after stereotactic radiosurgery for brain metastases in non-small cell lung cancer (NSCLC).

methodsA cohort of 89 out of 262 NSCLC patients (2003-2013) treated with gamma knife radiosurgery for brain metastases had genotyping available and were selected as our study population.

resultsMedian follow-up was 12 months. Median OS rates for the EGFR, KRAS, echinoderm microtubule-associated protein-like 4 (EML4)-ALK mutated, and wild-type cohorts were 17, 7, 27, and 12 months, respectively (P = .019), and for targeted versus nontargeted therapy 21 and 11 months, respectively (P = .071). Targeted therapy was a strong predictor of increased OS on univariate (P = .037) and multivariate (P = .022) analysis. Gender, primary tumor controlled status, recursive partitioning analysis class, and graded prognostic assessment score were associated with OS (P < .05). On multivariate analysis, positive EGFR mutational status was a highly significant predictor for decreased survival (hazard ratio: 8.2; 95% CI: 2.0-33.7; P = .003). However, when we recategorized EGFR-mutant cases based on whether they received tyrosine kinase inhibitor, OS was no longer significantly shorter (hazard ratio: 1.5; P = .471). Median OS for patients with and without local failure was 17 and 12 months, respectively (P = .577). Local failure rates for EGFR, KRAS, EML4-ALK mutated, and wild-type cohorts by lesion were 8.7%, 5.4%, 4.3%, and 5.1%, respectively.

conclusionsThis study suggests that EGFR tyrosine kinase mutation and ALK translocation results in improved survival to targeted therapies and that mutation status itself does not predict survival and local control in patients with brain metastases from NSCLC.

Indexed as

AdultAgedAged, 80 and overAnaplastic Lymphoma KinaseBrain NeoplasmsCarcinoma, Non-Small-Cell LungCell Cycle ProteinsEpidermal Growth FactorFemaleHumansLung NeoplasmsMaleMicrotubule-Associated ProteinsMiddle AgedMutationProportional Hazards ModelsALK protein, humanAlk protein, ratAnaplastic Lymphoma KinaseCell Cycle ProteinsEML4 protein, humanEpidermal Growth FactorKRAS protein, humanMicrotubule-Associated ProteinsProto-Oncogene Proteins p21(ras)Receptor Protein-Tyrosine KinasesSerine Endopeptidasesbrain metastasesmutationsnon-small cell lung cancerstereotactic radiosurgerytargeted therapy

Identifiers

PMID25910841
PMCPMC5762012
OpenAlexW2095918651

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