We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Clinicogenomic factors and treatment patterns among patients with advanced non–small cell lung cancer with or without brain metastases in the United States.
- Authors
Smyth, Emily Nash; John, Jincy; Tiu, Ramon V; Willard, Melinda Dale; Beyrer, Julie Kay; Bowman, Lee; Sheffield, Kristin M; Han, Yimei; Brastianos, Priscilla K
- Abstract
Background: This retrospective, real-world study evaluated the prevalence of brain metastases, clinicodemographic characteristics, systemic treatments, and factors associated with overall survival among patients with advanced non–small cell lung cancer (aNSCLC) in the US. We also described the genomic characterization of 180 brain metastatic specimens and frequency of clinically actionable genes. Materials and Methods: De-identified electronic health records-derived data of adult patients diagnosed with aNSCLC between 2011 and 2017 were analyzed from a US-nationwide clinicogenomic database. Results: Of 3257 adult patients with aNSCLC included in the study, approximately 31% (n = 1018) had brain metastases. Of these 1018 patients, 71% (n = 726) were diagnosed with brain metastases at initial NSCLC diagnosis; 57% (n = 583) of patients with brain metastases received systemic treatment. Platinum-based chemotherapy combinations were the most common first-line therapy; single-agent chemotherapies, epidermal growth factor receptor tyrosine kinase inhibitors, and platinum-based chemotherapy combinations were used in second line. Patients with brain metastases had a 1.56 times greater risk of death versus those with no brain metastases. In the brain metastatic specimens (n = 180), a high frequency of genomic alterations in the p53, MAPK, PI3K, mTOR, and cell-cycle associated pathways was observed. Conclusion: The frequency of brain metastases at initial clinical presentation and associated poor prognosis for patients in this cohort underscores the importance of early screening for brain metastasis in NSCLC. Genomic alterations frequently identified in this study emphasize the continued need for genomic research and investigation of targeted therapies in patients with brain metastases. This article evaluates the prevalence of brain metastases, clinicodemographic characteristics, systemic treatments, and factors associated with overall survival among patients with advanced non–small cell lung cancer in the US.
- Subjects
UNITED States; BRAIN tumor genetics; BRAIN tumor risk factors; THERAPEUTIC use of antineoplastic agents; LUNG cancer; PLATINUM compounds; SCIENTIFIC observation; CANCER chemotherapy; METASTASIS; RETROSPECTIVE studies; ACQUISITION of data; BRAIN tumors; CANCER patients; RISK assessment; PROTEIN-tyrosine kinase inhibitors; GENOMICS; MEDICAL records; SURVIVAL analysis (Biometry); SOCIODEMOGRAPHIC factors; OVERALL survival; DISEASE complications
- Publication
Oncologist, 2023, Vol 28, Issue 11, pe1075
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1093/oncolo/oyad170