Evidence map›Paper›PMID 30120912›Full record

ArticleCancer2018

Targeted sequencing and intracranial outcomes of patients with lung adenocarcinoma brain metastases treated with radiotherapy.

Robert H Press, Chao Zhang, Richard J Cassidy, Matthew J Ferris, Jim Zhong, Conor E Steuer, Rathi N Pillai, Taofeek K Owonikoko, Shannon Kahn, Suresh S Ramalingam and 5 more

Open access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in Cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 21% 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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Non-small cell lung cancer withFrontiers in oncology · 2023
    Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 1 institution in 1 country.

Robert H PressDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID 0000-0002-3297-3945
Chao ZhangBioinformatics and Biostatistics, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Richard J CassidyDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID 0000-0003-0019-0679
Matthew J FerrisDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Jim ZhongDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID 0000-0003-2251-6422
Conor E SteuerDepartment of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Rathi N PillaiDepartment of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Taofeek K OwonikokoDepartment of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Shannon KahnDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Suresh S RamalingamDepartment of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.ORCID 0000-0002-0757-3106
Pretesh R PatelDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Walter J CurranDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Hui-Kuo G ShuDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Gabriel L SicaDepartment of Pathology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Kristin A HigginsDepartment of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
Emory University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTreatment for advanced lung adenocarcinoma (AC) has become increasingly personalized based on molecular results. However, for patients with AC brain metastases (BMs), intracranial outcomes based on molecular subtype and the frequency of molecular aberrations are less well defined. This study sought to report targeted next-generation sequencing results and investigate molecularly based outcomes for patients with AC-BMs treated with radiotherapy.

methodsThe records of 132 patients with AC-BMs treated at Emory University from September 2008 to August 2016 with successful next-generation sequencing were reviewed. Rates of local disease recurrence, distant brain failure (DBF), and salvage whole-brain radiotherapy (WBRT) were estimated using cumulative incidence with competing risk analysis. Univariate and multivariate analyses were performed.

resultsThe most common aberrations included tumor protein 53 (TP53) (60%), KRAS (29%), epidermal growth factor receptor (EGFR) (20.5%), phosphatase and tensin homolog (PTEN) loss (15.5%), and MET amplification (13%). The majority of patients (62%) were treated with stereotactic radiosurgery alone. In these patients, KRAS mutation, anaplastic lymphoma kinase (ALK) rearrangement, and having ≥ 6 BMs were associated with an increased risk of salvage WBRT (P < .05). KRAS mutation remained significant for an increased risk of salvage WBRT when compared with EGFR/ALK/KRAS-negative patients (hazard ratio, 5.17; P < .05), despite a similar risk of DBF. PTEN loss was associated with increased risk of DBF (P < .05), whereas EGFR and ALK aberrations were associated with a decreased risk of local disease recurrence (P < .05).

conclusionsThe results of the current study quantified the frequency of genetic aberrations in patients with AC-BMs and demonstrated their association with intracranial outcomes. In particular, a cohort of patients with KRAS mutations and ≥6 BMs were identified to be at high risk of requiring salvage WBRT after undergoing upfront stereotactic radiosurgery.

Indexed as

Adenocarcinoma of LungAdultAgedAged, 80 and overAnaplastic Lymphoma KinaseBrain NeoplasmsCarcinoma, Non-Small-Cell LungCranial IrradiationDNA Mutational AnalysisErbB ReceptorsFollow-Up StudiesGene FrequencyHigh-Throughput Nucleotide SequencingHumansLung NeoplasmsMiddle AgedALK protein, humanAnaplastic Lymphoma KinaseEGFR protein, humanErbB ReceptorsKRAS protein, humanProto-Oncogene Proteins p21(ras)PTEN PhosphohydrolasePTEN protein, humanTP53 protein, humanTumor Suppressor Protein p53adenocarcinomabrain metastasesdistant brain failureDNA sequence analysisintracranial failureneoplasm metastasesnext-generation sequencingnon-small cell lung cancerstereotactic radiosurgerywhole-brain radiotherapy

Identifiers

PMID30120912
OpenAlexW2885471371

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.