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Brain metastases in Japanese NSCLC patients : prognostic assessment and the use of osimertinib and immune checkpoint inhibitors-retrospective study

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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
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
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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