Treatment and survival of patients with EGFR-mutated non-small cell lung cancer and leptomeningeal metastasis: A retrospective cohort analysis.

Autor: Kuiper JL; Department of Pulmonary Diseases, VU University Medical Center, Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: jl.kuiper@vumc.nl., Hendriks LE; Department of Pulmonary Diseases, GROW-School for Developmental Biology & Oncology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands., van der Wekken AJ; Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands., de Langen AJ; Department of Pulmonary Diseases, VU University Medical Center, Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Pulmonary Diseases, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands., Bahce I; Department of Pulmonary Diseases, VU University Medical Center, Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Pulmonary Diseases, Academic Medical Center, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands., Thunnissen E; Department of Pathology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands., Heideman DA; Department of Pathology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands., Berk Y; Department of Pulmonary Diseases, Canisius Wilhelmina hospital, P.O. Box 9015, 6500 GS Nijmegen, The Netherlands., Buijs EJ; Department of Pulmonary Diseases, VU University Medical Center, Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands., Speel EJ; Department of Pathology, GROW-School for Developmental Biology & Oncology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands., Krouwels FH; Department of Pulmonary Diseases, Spaarne Hospital, P.O. Box 770, 2130 AT Hoofddorp, The Netherlands., Smit HJ; Department of Pulmonary Diseases, Rijnstate Hospital, P.O. Box 9555, 6800 TA Arnhem, The Netherlands., Groen HJ; Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands., Dingemans AM; Department of Pulmonary Diseases, GROW-School for Developmental Biology & Oncology, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands., Smit EF; Department of Pulmonary Diseases, VU University Medical Center, Boelelaan 1117, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Pulmonary Diseases, The Netherlands Cancer Institute, P.O. Box 90203, 1006 BE Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2015 Sep; Vol. 89 (3), pp. 255-61. Date of Electronic Publication: 2015 Jun 06.
DOI: 10.1016/j.lungcan.2015.05.023
Abstrakt: Objectives: Development of leptomeningeal metastasis (LM) in non-small cell lung cancer (NSCLC)-patients is associated with a poor prognosis. It has been suggested that LM-patients with epidermal growth factor receptor mutated (EGFR+) NSCLC have a superior prognosis compared to EGFR-wild type NSCLC. Studies in EGFR+ NSCLC-patients with LM are scarce. We retrospectively evaluated a multi-institutional cohort of EGFR+ NSCLC-patients for LM to assess clinical outcome in relation to patient characteristics and treatment modalities.
Material and Methods: Medical records of advanced-stage EGFR+ NSCLC-patients (diagnosed between August 2000 and June 2014) from 11 Dutch hospitals were evaluated for LM as diagnosed by MRI and/or cytopathological liquor analysis. Data on patient characteristics, treatment and outcome were collected.
Results: Thirty-two of 356 (9.0%) advanced-stage EGFR+ NSCLC-patients (median follow-up 21.0 months), were diagnosed with LM between 2006 and 2014. LM was diagnosed by MRI (59.4%), liquor analysis (9.4%) or by both MRI and liquor analysis (31.3%). Median survival after LM-diagnosis was 3.1 months (95% CI: 0.0-7.3). Six- and 12-month survival rates were 43.8% and 18.8%, respectively. Patients with performance status (PS) 0-1 at time of diagnosis of LM had a significantly higher chance to be alive after 6 months and had a significantly longer survival after diagnosis of LM compared to patients with PS≥2. Age, treatment with high-dose EGFR-TKI, radiotherapy and whether LM was the only site of progressive disease did not influence survival after LM-diagnosis.
Conclusion: Although median survival after LM-diagnosis in EGFR-mutated NSCLC-patients was poor, a substantial part of the patients had a prolonged survival of more than 6 months. PS of 0-1 at time of diagnosis of LM was associated with prolonged survival. No other patient- or treatment-related characteristics were identified. Further research is warranted to identify treatment strategies that improve survival in EGFR+ NSCLC-patients with LM.
(Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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