Management and Outcomes of Newly Diagnosed Non-Small Cell Lung Cancer Patients with Brain Metastases: A Real-World Study in Japan

Abstract

Background: Brain metastases (BM) are one of the strongest negative prognostic factors in patients with non-small cell lung cancer (NSCLC). Molecularly targeted agents are standard of care for NSCLC patients with a driver mutation; however, their efficacy in patients with BM is not fully understood because patients with BM are usually excluded from clinical studies. This study investigated the current management and outcomes of newly diagnosed NSCLC patients with BM in Japanese clinical practice, focusing on their driver mutation status. Patients and Methods: We enrolled newly diagnosed, treatment-naïve NSCLC patients with BM between January 2012 and December 2015 from 4 institutions in Japan. The medical records of each patient were retrospectively reviewed, and the treatment details and outcomes were evaluated. Results: In total, 203 patients with BM were en-

Survival Outcomes of Local Compared With Systemic First Treatment of Non-Small Cell Lung Cancer Brain Metastases

“…The present study also showed that sufficient systemic therapy and TKI medication were associated with longer survival. This has been demonstrated in previous studies ( 17 , 18 ). Bo et al.…”

“…The present study also showed that sufficient systemic therapy and TKI medication were associated with longer survival. This has been demonstrated in previous studies (17,18). Bo et al (17) showed that systemic therapy plus either SRS or whole brain radiotherapy may significantly reduce the risk of mortality compared with radiotherapy alone for patients with one to three brain metastatic lesions of NSCLC.…”

“…Bo et al (17) showed that systemic therapy plus either SRS or whole brain radiotherapy may significantly reduce the risk of mortality compared with radiotherapy alone for patients with one to three brain metastatic lesions of NSCLC. Hironori et al (18) reported that, for patients with newly diagnosed brain metastases of NSCLC, the OS was significantly longer than that of patients without a driver mutation.…”

“…Hironori et al. ( 18 ) reported that, for patients with newly diagnosed brain metastases of NSCLC, the OS was significantly longer than that of patients without a driver mutation.…”

A Real-World Analysis of Patients with Untreated Metastatic Epidermal Growth Factor Receptor (EGFR)-Mutated Lung Adenocarcinoma Receiving First-Line Erlotinib and Bevacizumab Combination Therapy

“…In the NEJ026 study, only asymptomatic brain-metastatic patients were included [ 15 ]. Brain metastasis actually occurs frequently in advanced EGFR-mutated lung adenocarcinoma (15–30%), and additional local therapies, including surgery or radiation therapy, are needed in most cases [ 18 , 19 ]. In this study, seven patients received radiation therapy for brain metastasis in addition to combination therapy.…”