scholarly journals The Importance of Brain Metastasis in EGFR Mutation Positive NSCLC Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Vanita Noronha ◽  
Amit Joshi ◽  
Anant Gokarn ◽  
Vibhor Sharma ◽  
Vijay Patil ◽  
...  

Introduction. Brain metastasis is a poor prognostic marker in lung cancer. However it is not known whether amongst patients with EGFR mutation those with brain metastases have a worse outcome. Methods. We compared the survival outcomes between EGFR mutation positive patients with and without brain metastases. In this retrospective analysis of prospective database of all metastatic lung cancer patients at our centre between July 2009 and December 2012, patients were treated with either combination chemotherapy or oral TKI. All patients with brain metastases received whole brain radiation. Kaplan Meier method was used for survival analysis and compared using log rank test. Results. 101 patients with EGFR mutated, metastatic lung cancer were studied. Fourteen had brain metastases and 87 did not. The common EGFR mutations were exon 19 deletion (61.3%) and exon 21 L858R mutation (28.7%). Overall response was 64% in extracranial metastasis group as compared to 50% in brain metastasis group. There was a significant worsening of median OS in the patients with brain metastases (11.6 months) compared with only extracranial metastases (18.7 months), P=0.029. Conclusion. Amongst patients with EGFR mutant NSCLC, the presence of brain metastases leads to a worse outcome as compared to patients with extracranial metastases alone.

2021 ◽  
Vol 7 (5) ◽  
pp. 1-8
Author(s):  
Goulnar Kasymjanova ◽  

Our study is the first prospective clinical study using combination of curcumin and EGFR-TKIs in metastatic lung cancer patients. The future randomized larger-scale clinical trials using this combination is feasible and safe. RCT will seek to assess the potential effects on survival and response to TKIs


2019 ◽  
Vol 44 (5) ◽  
pp. 1917-1927 ◽  
Author(s):  
Francesco Alessandrino ◽  
Sonia Sahu ◽  
Mizuki Nishino ◽  
Anika E. Adeni ◽  
Sree Harsha Tirumani ◽  
...  

2020 ◽  
pp. 106002802096762
Author(s):  
Andrew H. Tam ◽  
Allison J. Schepers ◽  
Angel Qin ◽  
Victoria R. Nachar

Background: Zoledronic acid every 4 weeks (Q4wk) reduces the incidence of skeletal-related events (SREs) in patients with metastatic lung cancer. Lung cancer patients were excluded from extended-interval dosing trials (every 12 weeks [Q12wk]) that demonstrated noninferiority of the 2 dosing schemes. To date, the optimal dosing of zoledronic acid in metastatic lung cancer remains unknown. Objective: To determine whether zoledronic acid dosed Q12wk is similar to Q4wk dosing for prevention of SRE in patients with metastatic lung cancer. Methods: A retrospective analysis was performed in patients with non–small-cell lung cancer and small-cell lung cancer with bone metastases who received Q12wk and Q4wk zoledronic acid. The primary outcome was incidence of SRE at 1 year. Secondary analyses included time to first SRE, overall survival (OS), incidence of osteonecrosis of the jaw (ONJ), kidney dysfunction, and hypocalcemia. Results: A total of 34 patients received Q12wk and 46 patients received Q4wk zoledronic acid. Incidence of SRE at 1 year (Q12wk, 23.5%, vs Q4wk, 23.9%; 95% CI = −0.184 to 0.192; P = 0.968) and median time to SRE (not reached for either cohort; P = 0.530) did not differ. The Q12wk cohort had longer median OS (24.00 vs 8.97 months; P = 0.022). There were no differences in incidence of ONJ, kidney dysfunction, and hypocalcemia. Conclusion and Relevance: This is the first report examining extended-interval dosing of zoledronic acid in metastatic lung cancer. Incidence and time to SRE at 1 year were similar. This extended-interval dosing may be safe and reasonable for patients with lung cancer with bone metastases.


2014 ◽  
Vol 12 (1) ◽  
pp. 131 ◽  
Author(s):  
Audrey Mansuet-Lupo ◽  
Fouzia Zouiti ◽  
Marco Alifano ◽  
Anne Tallet ◽  
Marie-Christine Charpentier ◽  
...  

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 126-126 ◽  
Author(s):  
Jessica Ruth Bauman ◽  
Zofia Piotrowska ◽  
Emily Scribner ◽  
Brandon Temel ◽  
Rebecca Suk Heist ◽  
...  

126 Background: Metastatic lung cancer is the leading cause of cancer-related death in the US. In the last decade, however, patients (pts) with EGFR mutations have benefitted from improved outcomes with EGFR-directed targeted therapy. We hypothesized that this improvement might impact EOL care. The objective of this chart review was to describe the care of EGFR mutant pts with attention to EOL care, health care utilization, and palliative care use. Methods: With IRB approval, we retrospectively reviewed medical records of pts at our center diagnosed with advanced EGFR-mutant lung cancer from January 2009 to June 2012. We limited the review to pts who had at least one cancer therapy at MGH, and to those who died by June 2014. Results: 44 pts were included. 30 pts (68%) were female. 32 pts (73%) received cancer-directed therapy within 30 days of death. Of these, 30 pts (68%) received oral chemotherapy and 5 (11%) received IV chemotherapy. 30 pts (68%) were hospitalized within 30 days of death. Over their entire disease course, the median number of hospitalizations was 2 (0-8), and the median number of total inpatient days was 12 (0-88). 21 pts (48%) had a palliative care outpatient visit and 34 (77%) had an inpatient palliative care consult at some point during their care. 24 pts (54%) enrolled on hospice prior to death, 15 (34%) were never on hospice, and the hospice status of 5 (11%) was unknown. Of the 39 pts with known hospice status, median length of stay was 6 days (0-206). 23 pts (52%) died at home with hospice or in an inpatient hospice, 16 (36%) died in the hospital, 2 (4%) died at home without hospice, and the location of death was unknown for 3 (7%). Conclusions: Pts with EGFR mutations had high rates of hospitalization and chemotherapy use in the last month of life, and many died in the hospital. Palliative care utilization was high, but it is unclear how this affected EOL care. Designing innovative care models to support this unique population and understand EOL decision-making should be a priority.


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