2022 World Conference on Lung Cancer (ePosters)-EP08.02-071. Brain Metastases in EGFR-mutant NSCLC: Outcome of Osimertinib +/- Radiation Therapy in a Real-World Canadian Cohort

EP08.02-071. Brain Metastases in EGFR-mutant NSCLC: Outcome of Osimertinib +/- Radiation Therapy in a Real-World Canadian Cohort

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In patients with EGFR-mutant non-small cell lung cancer (NSCLC), intracranial metastases are a significant complication that is typically treated with cranial irradiation (RT) or surgical resection. However, these treatments can have considerable toxicities. Osimertinib, an oral tyrosine kinase inhibitor, has shown central nervous system (CNS) activity. This study aimed to compare the outcomes of patients treated with Osimertinib, with or without RT. <br /><br />A retrospective study was conducted on EGFR-mutant NSCLC patients with brain metastases in Alberta, Canada who were treated with Osimertinib between July 2018 and January 2021. The primary endpoint was median overall survival (mOS), and the secondary endpoint was the median time to treatment failure (mTTF). Kaplan-Meier survival curves were used to assess survival outcomes. <br /><br />Among the 36 patients identified, 15 received Osimertinib only, while 21 received Osimertinib plus brain radiation. The two groups did not differ significantly in terms of demographic or clinical characteristics. A multivariate analysis showed that ECOG 2 (Eastern Cooperative Oncology Group performance status) was an independent factor for survival. A complete CNS response was observed in 19% of patients in the Osimertinib group and 5% in the Osimertinib plus RT group. <br /><br />There were no significant differences in mOS and mTTF between Osimertinib patients treated with or without RT. These findings suggest that Osimertinib alone can provide good efficacy in controlling CNS metastases, potentially avoiding the toxicities associated with RT. Future studies are needed to determine predictive characteristics for CNS response in EGFR-mutant NSCLC patients treated with Osimertinib.<br /><br />Overall, this study indicates that Osimertinib alone may be effective in controlling brain metastases in certain patients, sparing them from potential radiation therapy-associated toxicities.

Asset Subtitle

Ishjot Litt

Meta Tag

Speaker Ishjot Litt

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

EGFR-mutant non-small cell lung cancer

intracranial metastases

cranial irradiation

surgical resection

Osimertinib

tyrosine kinase inhibitor

central nervous system activity

retrospective study

overall survival

time to treatment failure