Evidence map›Paper›PMID 41168138›Full record

ArticleJournal of the Chinese Medical Association : JCMA2025

BBB-penetrant tyrosine kinase inhibitor plus intracranial radiotherapy vs BBB-penetrant TKI alone in Asians with EGFR-mutated lung adenocarcinoma and brain metastases.

You-Cong Chen, Chun-Fu Lin, Chi-Lu Chiang, Huai-Che Yang, Hsiu-Mei Wu, Ching-Jen Chen, Yung-Hung Luo, Yong-Sin Hu, Chung-Jung Lin, Wen-Yuh Chung and 4 more

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Article in Journal of the Chinese Medical Association : JCMA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
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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

14 authors.

You-Cong ChenDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chun-Fu LinDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Chi-Lu ChiangSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Huai-Che YangDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Hsiu-Mei WuSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Ching-Jen ChenDepartment of Neurosurgery, The University of Texas Health Science Center, Houston, TX, USA.
Yung-Hung LuoSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Yong-Sin HuSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Chung-Jung LinSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Wen-Yuh ChungDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Cheng-Ying ShiauSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Wan-Yuo GuoSchool of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
David Hung-Chi PanDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Cheng-Chia LeeDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOsimertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), penetrates the blood-brain barrier and provides intracranial tumor control in non-small-cell lung cancer (NSCLC). This study investigated whether combining osimertinib with intracranial radiotherapy (RT) improved outcomes in the patients with EGFR-mutant lung adenocarcinoma and brain metastases.

methodsThis is a retrospective analysis included patients who took osimertinib accompanying with or without RT between 2014 and 2022 from a single tertiary medical center. At least one session of magnetic resonance imaging and clinical follow-up after treatment. Outcomes assessed were intracranial local control, intracranial distant control, and overall survival (OS). Kaplan-Meier curves were used for outcome demonstration. Cox regression analysis was also used to identify independent predictors from age, gender, smoking, characteristics of brain metastases, KPS, gene types (presence of T790M), and radiation modalities.

resultsA total of 567 brain metastases from 69 patients were enrolled: TKI alone (n = 38) and TKI + RT (n = 31). Intracranial local control was significantly higher with TKI+RT compared with TKI alone (77% vs 23%; p < 0.01) at 3-year follow-up. Intracranial distant control was also longer in the TKI + RT group (23.2 vs 8.7 months in median; p < 0.01). No significant difference in OS was observed between the two groups ( p = 0.27). Multivariable analysis demonstrated that the presence of T790M mutation ( p = 0.01) and TKI + RT ( p = 0.01) were associated with improved intracranial local control, while TKI + RT was also associated with improved intracranial distant control ( p = 0.03).

conclusionThe addition of RT to osimertinib enhanced intracranial local and distant control in the patients with EGFR-mutant lung adenocarcinoma and brain metastases, although no survival benefit was observed. Prospective studies are warranted to validate these findings.

Indexed as

AcrylamidesAdenocarcinoma of LungAniline CompoundsBlood-Brain BarrierBrain NeoplasmsLung NeoplasmsMutationProtein Kinase InhibitorsAdultAgedAged, 80 and overEast Asian PeopleErbB ReceptorsFemaleHumansIndolesAcrylamidesAniline CompoundsEGFR protein, humanErbB ReceptorsIndolesosimertinibProtein Kinase InhibitorsPyrimidinesTyrosine Kinase InhibitorsBrain metastasesGamma-knife radiosurgeryNon–small-cell lung cancerOsimertinibTyrosine kinase inhibitor

Identifiers

PMID41168138
PMCPMC12742707

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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.