Evidence map›Paper›PMID 36227422›Full record

ArticleJournal of neuro-oncology2022

Local control of brain metastases with osimertinib alone in patients with EGFR-mutant non-small cell lung cancer.

Caressa Hui, Vera Qu, Jen-Yeu Wang, Rie von Eyben, Yu-Cheng Chang, Po-Lin Chiang, Chih-Hung Liang, Jen-Tang Lu, Gordon Li, Melanie Hayden-Gephart and 8 more

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.5field-weighted citation impact, top 16% 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

6 citing papers in PubMed, 10 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

18 authors at 1 institution in 1 country.

Caressa HuiDepartment of Radiation Oncology, Stanford University, Palo Alto, CA, USA.
Vera QuDepartment of Radiation Oncology, Stanford University, Palo Alto, CA, USA.
Jen-Yeu WangDepartment of Radiation Oncology, Stanford University, Palo Alto, CA, USA.
Rie von EybenDepartment of Radiation Oncology, Stanford University, Palo Alto, CA, USA.
Yu-Cheng ChangVysioneer Inc, Cambridge, MA, USA.
Po-Lin ChiangVysioneer Inc, Cambridge, MA, USA.
Chih-Hung LiangVysioneer Inc, Cambridge, MA, USA.
Jen-Tang LuVysioneer Inc, Cambridge, MA, USA.
Gordon LiDepartment of Neurosurgery, Stanford University, Palo Alto, CA, USA.
Melanie Hayden-GephartDepartment of Neurosurgery, Stanford University, Palo Alto, CA, USA.
Heather WakeleeDepartment of Medical Oncology, Stanford University, Palo Alto, CA, USA.
Joel NealDepartment of Medical Oncology, Stanford University, Palo Alto, CA, USA.
Kavitha RamchandranDepartment of Medical Oncology, Stanford University, Palo Alto, CA, USA.
Millie DasDepartment of Medical Oncology, Stanford University, Palo Alto, CA, USA.
Seema NagpalDepartment of Neurology, Stanford University, Palo Alto, CA, USA.
Scott SoltysDepartment of Radiation Oncology, Stanford University, Palo Alto, CA, USA.
Nathaniel MyallDepartment of Medical Oncology, Stanford University, Palo Alto, CA, USA. nmyall@stanford.edu.
Erqi PollomDepartment of Radiation Oncology, Stanford University, Palo Alto, CA, USA. erqiliu@stanford.edu.
Stanford University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAlthough osimertinib has excellent intracranial activity in metastatic non-small cell lung cancer (NSCLC) with exon 19 deletion or L858R EGFR alterations, measures of local control of brain metastases are less well-reported. We describe lesion-level outcomes of brain metastases treated with osimertinib alone.

methodsWe retrospectively reviewed patients with EGFR-mutant NSCLC with untreated brain metastasis measuring ≥ 5 mm at the time of initiating osimertinib. Cumulative incidence of local recurrence in brain (LRiB) was calculated with death as a competing risk, and univariable and multivariable analyses were conducted to identify factors associated with LRiB.

resultsWe included 284 brain metastases from 37 patients. Median follow-up was 20.1 months. On initial MRI after starting osimertinib, patient-level response was complete response (CR) in 11 (15%), partial response (PR) in 33 (45%), stable disease (SD) in 18 (25%) and progressive disease (PD) in 11 (15%). The 1-year cumulative incidence of LRiB was 14% (95% CI 9.9-17.9) and was significantly different in patients with a CR (0%), PR (4%), and SD (11%; p = 0.02). Uncontrolled primary tumor (adjusted hazard ratio [aHR] 3.78, 95% CI 1.87-7.66; p < 0.001), increasing number of prior systemic therapies (aHR 2.12, 95% CI 1.49-3.04; p < 0.001), and higher ECOG score (aHR 7.8, 95% CI 1.99-31.81; p = 0.003) were associated with LRiB.

conclusionsAlthough 1-year cumulative incidence of LRiB is < 4% with a CR or PR, 1-year cumulative incidence of LRiB is over 10% for patients with less than a PR to osimertinib on initial MRI. These patients should be followed closely for need for additional treatment such as stereotactic radiosurgery.

Indexed as

Brain NeoplasmsCarcinoma, Non-Small-Cell LungLung NeoplasmsProtein Kinase InhibitorsAcrylamidesAniline CompoundsErbB ReceptorsHumansIndolesMutationPyrimidinesRetrospective StudiesAcrylamidesAniline CompoundsEGFR protein, humanErbB ReceptorsIndolesosimertinibProtein Kinase InhibitorsPyrimidinesNSCLCOsimertinibRadiationRadiation oncologySRSTKI

Identifiers

PMID36227422
OpenAlexW4304976245

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.