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Hokkaido University Collection of Scholarly and Academic Papers >
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Brain metastases in Japanese NSCLC patients : prognostic assessment and the use of osimertinib and immune checkpoint inhibitors-retrospective study
| Title: | Brain metastases in Japanese NSCLC patients : prognostic assessment and the use of osimertinib and immune checkpoint inhibitors-retrospective study |
| Authors: | Higaki, Hajime Browse this author | | Nishioka, Kentaro Browse this author | | Otsuka, Manami Browse this author | | Nishikawa, Noboru Browse this author | | Shido, Motoyasu Browse this author | | Minatogawa, Hideki Browse this author | | Nishikawa, Yukiko Browse this author | | Takashina, Rikiya Browse this author | | Hashimoto, Takayuki Browse this author | | Katoh, Norio Browse this author | | Taguchi, Hiroshi Browse this author | | Kinoshita, Rumiko Browse this author | | Yasuda, Koichi Browse this author | | Mori, Takashi Browse this author | | Uchinami, Yusuke Browse this author | | Koizumi, Fuki Browse this author | | Fujita, Yoshihiro Browse this author | | Takahashi, Shuhei Browse this author | | Hattori, Takahiro Browse this author | | Nishiyama, Noriaki Browse this author | | Aoyama, Hidefumi Browse this author →KAKEN DB |
| Keywords: | DS-GPA | | Lung-molGPA | | Brain metastasis | | Lung cancer | | Retrospective study |
| Issue Date: | 7-Feb-2023 |
| Publisher: | BioMed Central |
| Journal Title: | Radiation oncology (London, England) |
| Volume: | 18 |
| Issue: | 1 |
| Start Page: | 25 |
| Publisher DOI: | 10.1186/s13014-023-02218-3 |
| Abstract: | BackgroundThe Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA) has not been validated for use with Japanese non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) and the factors impacting survival need to be assessed.MethodsWe retrospectively analyzed 294 NSCLC patients who were newly diagnosed with BM between 2013 and 2020 and had received radiotherapy for BM initially at the Hokkaido Cancer Center. We evaluated the effect on the prognosis of Lung-molGPA items, the expression of PD-L1 (classified as high, low, and no expression), and the treatment history. The main outcome was the survival measured from the day of the diagnosis of BM, and log-rank tests were performed to evaluate the results.ResultsThe median overall survival (OS) times for adenocarcinoma by groups of GPA scores (0-1.0, 1.5-2.0, 2.5-3.0, and 3.5-4.0) were 5.5, 14.8, 28.3, and 39.0 months (p < 0.0001), respectively. The median survival times for non-adenocarcinoma by groups of GPA scores (0-1.0, 1.5-2.0, and 2.5-3.0) were 3.2, 11.0, and 16.0 months (p = 0.0011), respectively. In adenocarcinoma patients with gene mutations, osimertinib significantly improved the outcome (median OS: 34.2 and 17.6 months with and without osimertinib, respectively (p = 0.0164)). There was no significant difference in the OS between patients who were initially treated with tyrosine-kinase inhibitor for BM and those who initially received radiotherapy (p = 0.5337). In patients tested for PD-L1 expression, the median survival times after the diagnosis of BM were 5.6, 22.5, and 9.3 months for the high-, low- and no-expression groups (p = 0.2198), respectively. Also, in patients with high PD-L1 expressions, those with ICI had survival (median OS, 8.6 months) than those without (median OS, 3.6 months).ConclusionsWe confirmed that Lung-molGPA successfully classified Japanese NSCLC patients with BM by the prognosis. Osimertinib prolonged survival of EGFR-positive NSCLC patients with BM, and ICI was effective in patients with high PD-L1 expressions. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/88928 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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