The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients With Adenocarcinoma of the Lung and Brain Metastases.
The Effect of Gene Alterations and Tyrosine Kinase Inhibition on Survival and Cause of Death in Patients With Adenocarcinoma of the Lung and Brain Metastases.
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基因改变和酪氨酸激酶抑制对肺腺癌和脑转移患者的存活和死亡原因的影响。
DOI：
10.1016/j.ijrobp.2016.06.006
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发表时间：
2016-10-01
期刊：
影响因子：
--
通讯作者：
Mehta MP
中科院分区：
文献类型：
--
作者：
Sperduto PW;Yang TJ;Beal K;Pan H;Brown PD;Bangdiwala A;Shanley R;Yeh N;Gaspar LE;Braunstein S;Sneed P;Boyle J;Kirkpatrick JP;Mak KS;Shih HA;Engelman A;Roberge D;Arvold ND;Alexander B;Awad MM;Contessa J;Chiang V;Hardie J;Ma D;Lou E;Sperduto W;Mehta MP
Lung cancer remains the most common cause of both cancer mortality and brain metastases (BM). The purpose of this study was to assess the effect of gene alterations and tyrosine kinase inhibition (TKI) on median survival (MS) and cause of death (CoD) in patients with BM from lung adenocarcinoma (L-adeno). A multi-institutional retrospective database of patients with L-adeno and newly diagnosed BM between 2006 and 2014 was created. Demographics, gene alterations, treatment, MS, and CoD were analyzed. The treatment patterns and outcomes were compared with those in prior trials. Of 1521 L-adeno patients, 816 (54%) had known alteration status. The gene alteration rates were 29%, 10%, and 26% for EGFR, ALK, and KRAS, respectively. The time from primary diagnosis to BM for EGFR−/+ was 10/15 months (P=.02) and for ALK−/+ was 10/20 months (P<.01), respectively. The MS for the group overall (n=1521) was 15 months. The MS from first treatment for BM for EGFR and ALK−, EGFR+, ALK+ were 14, 23 (P<.01), and 45 (P<.0001) months, respectively. The MS after BM for EGFR+ patients who did/did not receive TKI before BM was 17/30 months (P<.01), respectively, but the risk of death was not statistically different between TKI-naïve patients who did/did not receive TKI after the diagnosis of BM (EGFR/ALK hazard ratios: 1.06 [P=.84]/1.60 [P=.45], respectively). The CoD was nonneurologic in 82% of patients with known CoD. EGFR and ALK gene alterations are associated with delayed onset of BM and longer MS relative to patients without these alterations. The CoD was overwhelmingly nonneurologic in patients with known CoD.
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DOI：
10.1016/j.ijrobp.2012.11.042
发表时间：
2013-04-01
影响因子：
7
作者：
Sperduto, Paul W.;Wang, Meihua;Robins, H. Ian;Schell, Michael C.;Werner-Wasik, Maria;Komaki, Ritsuko;Souhami, Luis;Buyyounouski, Mark K.;Khuntia, Deepak;Demas, William;Shah, Sunjay A.;Nedzi, Lucien A.;Perry, Gad;Suh, John H.;Mehta, Minesh P.
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影响因子：
120.7
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DOI：
10.1016/s0360-3016(96)00619-0
发表时间：
1997-03-01
影响因子：
7
作者：
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通讯作者：
Byhardt, R
DOI：
10.1016/j.ijrobp.2009.08.025
发表时间：
2010-07-01
影响因子：
7
作者：
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通讯作者：
Mehta, Minesh
影响因子：
45.3
作者：
Sperduto, Paul W.;Kased, Norbert;Mehta, Minesh
通讯作者：
Mehta, Minesh