Brain metastases in patients with EGFR-mutated or ALK-rearranged non-small-cell lung cancers.
Brain metastases in patients with EGFR-mutated or ALK-rearranged non-small-cell lung cancers.
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EGFR突变或藻类重新培养的非小细胞肺癌患者的脑转移。
DOI：
10.1016/j.lungcan.2015.01.020
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发表时间：
2015-04
期刊：
影响因子：
--
通讯作者：
Costa DB
中科院分区：
文献类型：
--
作者：
Rangachari D;Yamaguchi N;VanderLaan PA;Folch E;Mahadevan A;Floyd SR;Uhlmann EJ;Wong ET;Dahlberg SE;Huberman MS;Costa DB
脑转移（BM）在非小细胞肺癌（NSCLC）中很常见。然而，在癌基因驱动的NSCLC中，BM的基线发生率和随时间的演变很少报道。在这项研究中，我们评估了表皮生长因子受体（EGFR）突变或间变性淋巴瘤激酶（ALK）重排NSCLC患者中BM的频率。对381例患者的BM、临床病理资料和肿瘤基因型进行回顾性分析。我们确定了86例EGFR突变（90.7%患有转移性疾病; 85.9%接受了EGFR抑制剂）和23例ALK重排（91.3%患有转移性疾病; 85.7%接受了ALK抑制剂）NSCLC。在诊断晚期疾病时，24.4%的EGFR突变和23.8%的ALK重排NSCLC中存在BM。本研究未证明两个队列之间BM累积发生率随时间的差异（EGFR/ALK队列竞争风险回归[CRR]系数为0. 78 [95% CI 0. 44 - 1. 39]，p= 0. 41）。在仍存活的晚期EGFR突变NSCLC患者中，34.2%在1年时有BM，38.4%在2年时有BM，46.7%在3年时有BM，48.7%在4年时有BM，52.9%在5年时有BM。在仍存活的晚期ALK重排NSCLC患者中，23.8%的患者在1年时有BM，45.5%的患者在2年时有BM，58.4%的患者在3年时有BM。BM在晚期EGFR突变或ALK重排的NSCLC中常见，估计使用靶向治疗后3年生存期内CNS受累患者>45%。这些数据表明，在NSCLC个性化治疗的不断发展的方案中，CNS是一个重要的未满足的临床需求。
Brain metastases (BM) are common in non-small-cell lung cancer (NSCLC). However, the baseline incidence and evolution of BM over time in oncogene-driven NSCLCs are seldom reported. In this study, we evaluated the frequency of BM in patients with epidermal growth factor receptor (EGFR)-mutated or anaplastic lymphoma kinase (ALK)-rearranged NSCLC. The presence of BM, clinicopathologic data, and tumor genotype were retrospectively compiled and analyzed from a cohort of 381 patients. We identified 86 EGFR-mutated (90.7% with metastatic disease; 85.9% received an EGFR inhibitor) and 23 ALK-rearranged (91.3% with metastatic disease; 85.7% received an ALK inhibitor) NSCLCs. BM were present in 24.4% of EGFR-mutated and 23.8% of ALK-rearranged NSCLCs at the time of diagnosis of advanced disease. This study did not demonstrate a difference in the cumulative incidence of BM over time between the two cohorts (EGFR/ALK cohort competing risk regression [CRR] coefficient of 0.78 [95% CI 0.44–1.39], p=0.41). In still living patients with advanced EGFR-mutated NSCLC, 34.2% had BM at 1 year, 38.4% at 2 years, 46.7% at 3 years, 48.7% at 4 years, and 52.9% at 5 years. In still living patients with advanced ALK-rearranged NSCLC, 23.8% had BM at 1 year, 45.5% at 2 years, and 58.4% at 3 years. BM are frequent in advanced EGFR-mutated or ALK-rearranged NSCLCs, with an estimated >45% of patients with CNS involvement by three years of survival with the use of targeted therapies. These data point toward the CNS as an important unmet clinical need in the evolving schema for personalized care in NSCLC.
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影响因子：
6.2
作者：
Doebele RC;Lu X;Sumey C;Maxson DA;Weickhardt AJ;Oton AB;Bunn PA Jr;Barón AE;Franklin WA;Aisner DL;Varella-Garcia M;Camidge DR
通讯作者：
Camidge DR
DOI：
10.1016/j.lungcan.2014.01.013
发表时间：
2014-04
期刊：
Lung cancer (Amsterdam, Netherlands)
影响因子：
--
作者：
Vanderlaan PA;Yamaguchi N;Folch E;Boucher DH;Kent MS;Gangadharan SP;Majid A;Goldstein MA;Huberman MS;Kocher ON;Costa DB
通讯作者：
Costa DB
DOI：
10.1016/j.lungcan.2013.07.013
发表时间：
2013-10
期刊：
Lung cancer (Amsterdam, Netherlands)
影响因子：
--
作者：
Yamaguchi N;Vanderlaan PA;Folch E;Boucher DH;Canepa HM;Kent MS;Gangadharan SP;Majid A;Kocher ON;Goldstein MA;Huberman MS;Costa DB
通讯作者：
Costa DB
影响因子：
45.3
作者：
Barnholtz-Sloan, JS;Sloan, AE;Sawaya, RE
通讯作者：
Sawaya, RE
影响因子：
15.9
作者：
Eichler, April F.;Kahle, Kristopher T.;Sequist, Lecia V.
通讯作者：
Sequist, Lecia V.