Evidence map›Paper›PMID 32902767›Full record

ArticleJournal of neuro-oncology2020

Intracranial disease control for EGFR-mutant and ALK-rearranged lung cancer with large volume or symptomatic brain metastases.

Sunil W Dutta, Marie L Mack, Eric Aliotta, Kristin A Ward, Donald A Muller, James M Larner, Camilo E Fadul, Richard D Hall, Ryan D Gentzler, Jason P Sheehan

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.9field-weighted citation impact, top 22% 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

8 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
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

10 authors at 2 institutions in 1 country.

Sunil W DuttaDepartment of Radiation Oncology, University of Virginia, PO Box 800383, Charlottesville, VA, 22908, USA. nwdutta@gmail.com.ORCID http://orcid.org/0000-0003-3574-6569
Marie L MackDepartment of Radiation Oncology, University of Virginia, PO Box 800383, Charlottesville, VA, 22908, USA.
Eric AliottaDepartment of Radiation Oncology, University of Virginia, PO Box 800383, Charlottesville, VA, 22908, USA.
Kristin A WardDepartment of Radiation Oncology, University of Virginia, PO Box 800383, Charlottesville, VA, 22908, USA.
Donald A MullerDepartment of Radiation Oncology, University of Virginia, PO Box 800383, Charlottesville, VA, 22908, USA.
James M LarnerDepartment of Radiation Oncology, University of Virginia, PO Box 800383, Charlottesville, VA, 22908, USA.
Camilo E FadulDepartment of Neurology, University of Virginia, Charlottesville, VA, USA.
Richard D HallDepartment of Medicine, University of Virginia, Charlottesville, VA, USA.
Ryan D GentzlerDepartment of Medicine, University of Virginia, Charlottesville, VA, USA.
Jason P SheehanDepartment of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
University of Virginia · USNeurological Surgery · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

PURPOSE/OBJECTIVE(S): Tyrosine kinase inhibitors (TKIs) are commonly employed for patients with brain metastases from lung cancer and specific driver mutations. We sought to identify the correlation between intracranial tumor burden and outcomes in patients with brain metastases treated with TKIs. MATERIALS/

methodsWe identified and retrospectively reviewed cases of EGFR-mutant or ALK-rearranged lung cancer with brain metastases at any time during their cancer course. Clinical characteristics and treatment information were abstracted from the medical records. Brain metastases were contoured to calculate total volume of disease at diagnosis and after initial therapy. High intracranial burden was defined as either > 10 brain metastases, volume of brain metastases > 15 cc, or largest lesion > 3 cm. Intracranial response was determined according to Response Assessment in Neuro-Oncology (RANO) criteria on the patient level. We determined the correlation between clinical and imaging characteristics and intracranial progression free survival (IC-PFS) and overall survival (OS).

resultsFifty-seven patients with EGFR (n = 49) and ALK (n = 8) alterations were identified. Median follow-up from initial brain metastasis diagnosis was 17 months. Neurological symptoms were present in 54% at brain metastasis diagnosis. For those receiving TKIs alone or TKIs with radiation, at least a partial intracranial response (≥ 65% volume reduction) at 3 months from starting therapy was achieved in 94% and 58%. Progressive intracranial disease at 3 months occurred in 6.3% and 8.3%. Patients with high intracranial burden (n = 21) had a median 17 brain metastases, 6.5 cc volume, and 1.9 cm maximal tumor diameter. Median IC-PFS and OS for patients with high intracranial burden was 13.9 and 35.4 months. Patients with high intracranial burden and neurological symptoms at diagnosis had similar IC-PFS and OS compared to those with low burden and absence of neurological symptoms (p > 0.05 for each).

conclusionMost patients receiving TKIs as part of their initial therapy achieve an early and durable volumetric intracranial response, irrespective of presenting disease burden or neurologic symptoms.

Indexed as

Gene RearrangementMutationAdultAgedAged, 80 and overAnaplastic Lymphoma KinaseBiomarkers, TumorBrain NeoplasmsCarcinoma, Non-Small-Cell LungCombined Modality TherapyCranial IrradiationErbB ReceptorsFemaleFollow-Up StudiesHumansLung NeoplasmsALK protein, humanAnaplastic Lymphoma KinaseBiomarkers, TumorEGFR protein, humanErbB ReceptorsProtein Kinase InhibitorsBrain metastasesNSCLCRadiationTKI

Identifiers

PMID32902767
OpenAlexW3084835719

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.