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. 2018 Jan;33(1):168-175.
doi: 10.3904/kjim.2015.158. Epub 2016 Apr 20.

Epidermal growth factor receptor mutation and pattern of brain metastasis in patients with non-small cell lung cancer

Min Young Baek  1 , Hee Kyung Ahn  1 , Kyu Ree Park  1 , Hwa-Sun Park  2 , Shin Myung Kang  3 , Inkeun Park  1 , Young Saing Kim  1 , Junshik Hong  1 , Sun Jin Sym  1 , Jinny Park  1 , Jae Hoon Lee  1 , Dong Bok Shin  1 , Eun Kyung Cho  1
Affiliations

Epidermal growth factor receptor mutation and pattern of brain metastasis in patients with non-small cell lung cancer

Min Young Baek et al. Korean J Intern Med. 2018 Jan.

Abstract

Background/aims: We investigated the time taken for patients with metastatic non-small cell lung cancer (NSCLC) to develop brain metastases (BM), as well as their subsequent overall median survival following diagnosis, considering the epidermal growth factor receptor (EGFR) mutational status.

Methods: We retrospectively investigated the medical records of 259 patients diagnosed with advanced NSCLC from January 2010 to August 2013, who were tested for EGFR mutations. The time from the diagnosis of advanced NSCLC to the development of BM and the overall median survival after BM development (BM-OS) were evaluated and compared by EGFR mutational status.

Results: Sixty-seven patients (25.9%) developed BM. Synchronous BM occurred more often in patients with EGFR mutation type (MT) (n = 20, 27.4%) compared with EGFR wild type (WT) (n = 27, 14.5%, p < 0.009). The median BM-OS was significantly longer in patients with EGFR MT than in those with EGFR WT (25.7 months vs. 3.8 months, p < 0.001), and a similar trend was noticed for patients with synchronous BM (25.7 months for EGFR MT vs. 6.8 months for EGFR WT, p < 0.001). However, in patients with metachronous BM development, the difference in BM-OS between patients with EGFR MT (14.6 months) and EGFR WT (2.5 months) did not reach statistical significance (p = 0.230).

Conclusions: Synchronous BM was more common in NSCLC patients with EGFR MT than in those with EGFR WT. However, EGFR mutations were associated with significantly longer median BM-OS, especially when the brain was the first metastatic site.

Keywords: Brain metastases; Carcinoma, non-small-cell lung; Prognosis; Receptor, epidermal growth factor.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Time to brain metastases compared by epidermal growth factor receptor (EGFR) mutational status in 20 nonsmall cell lung cancer patients with metachronous brain metastases. EGFR mutation type (MT, dashed line) vs. EGFR wild type (WT, solid line).
Figure 2.
Figure 2.
Investigating the relationship between epidermal growth factor receptor (EGFR) status and overall survival (OS) of non-small cell lung cancer (NSCLC) patients. OS of patients from the time of diagnosis of stage IV NSCLC (A) or diagnosis of brain metastases (BM-OS) (B) compared by EGFR mutational status. EGFR mutation type (MT, dashed line) vs. EGFR wild type (WT, solid line).
Figure 3.
Figure 3.
Overall survival of non-small cell lung cancer patients according to timing of brain metastases. Overall survival from the time of diagnosis of brain metastases (BM-OS) by epidermal growth factor receptor (EGFR) mutational status among patients with synchronous (A) or metachronous (B) development of brain metastases. EGFR mutant type (MT, dashed line) vs. EGFR (WT, solid line).
See this image and copyright information in PMC

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