ArticleClinical and translational radiation oncology2019
EGFR mutant locally advanced non-small cell lung cancer is at increased risk of brain metastasis.
Article in Clinical and translational radiation oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Changing Treatment and Metastatic Disease Patterns in Patients with EGFR Mutated NSCLC: An Academic Thoracic Medical Investigator's Consortium Registry Analysis.JTO clinical and research reports · 2025Article
- Integration of continuous lumbar drainage and third-generation EGFR-TKI in managing leptomeningeal metastasis-induced life-threatening intracranial hypertension: a case report.Frontiers in oncology · 2025Article
- Development of brain metastases in patients managed with non-curative thoracic radiotherapy for stage II/III non-small cell lung cancer.Discover oncology · 2024Article
- Prognostic Factors in Postoperative Brain Metastases Derive From Non-small Cell Lung Cancer: A Retrospective Analysis.Clinical Medicine Insights. Oncology · 2024Article
- Multiregional radiomics of brain metastasis can predict response to EGFR-TKI in metastatic NSCLC.European radiology · 2023Article
- Leptomeningeal Metastasis: A Review of the Pathophysiology, Diagnostic Methodology, and Therapeutic Landscape.Current oncology (Toronto, Ont.) · 2023Review
- Identification of predictors for brain metastasis in newly diagnosed non-small cell lung cancer: a single-center cohort study.European radiology · 2022Article
- Epidermal growth factor receptor mutations and brain metastases in non-small cell lung cancer.Frontiers in oncology · 2022Review
- Observational
- Identification of a high-risk group for brain metastases in non-small cell lung cancer patients.Journal of neuro-oncology · 2021Article
- Epidemiology of brain metastases and leptomeningeal disease.Neuro-oncology · 2021Review
- Targeted therapies for unresectable stage III non-small cell lung cancer.Mediastinum (Hong Kong, China) · 2021Review
- Perspective on treatment for unresectable locally advanced non-small cell lung cancer with oncogene-driven mutation: a narrative review.Translational lung cancer research · 2020Review
- Intracranial disease control for EGFR-mutant and ALK-rearranged lung cancer with large volume or symptomatic brain metastases.Journal of neuro-oncology · 2020Article
- Non-small cell lung cancer with synchronous brain metastases: Identification of prognostic factors in a retrospective multicenter study (HOT 1701).Neuro-oncology advancesArticle
- Brain Metastasis Incidence and Patterns of Presentation After Definitive Treatment of Locally Advanced Non-Small Cell Lung Cancer: A Potential Argument for Brain Magnetic Resonance Imaging Surveillance.Advances in radiation oncologyArticle
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeSmall studies of primarily metastatic non-small cell lung cancer (NSCLC) have suggested an association between EGFR mutation (EGFR+) and likelihood of brain metastasis. However, these studies are confounded by follow-up time bias. We performed a competing risk analysis of brain metastasis in a more uniform locally advanced NSCLC (LA-NSCLC) cohort with known tumor genotype. MATERIALS AND
methodsBetween 2002 and 2014, 255 patients with LA-NSCLC underwent tumor genotyping for EGFR, ALK and/or KRAS (180 patients had follow-up brain imaging). Cumulative incidence and Fine-Gray regression were performed on clinical variables including genotype and risk of brain metastasis, with death as a competing event.
resultsThe proportion of tumors with aberrations in EGFR, ALK and KRAS were 17%, 4% and 28%, respectively. The median follow-up was 68 months. On multivariate analysis, EGFR+ was significantly associated with risk of brain metastasis in the full patient cohort (HR 2.04, 95% CI 1.22-3.39, p = 0.006) as well as in the subset of patients with brain follow-up imaging (HR 1.91. 95% CI 1.17-3.13, p = 0.01). This translated to a higher cumulative incidence of brain metastasis in EGFR+ patients at 3 and 5 years (33.3% vs. 23.2 and 43.8% vs. 24.2%, p = 0.006).
conclusionPatients with EGFR+ LA-NSCLC have a significantly higher likelihood of developing brain metastasis after standard combined modality therapy, independent of their longer overall survival. This high-risk genotypic subgroup may benefit from routine surveillance with brain MRI to allow early salvage with targeted systemic- and/or radiation-therapies.
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