- Intracranial PFS or OS did not differ significantly after whole-brain radiotherapy (WBRT) for brain metastases in NSCLC with or without resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs).
- However, in a subgroup of patients with a Lung Cancer Using Molecular Markers Graded Prognostic Assessment (Lung-molGPA) score of 2.5-4, those with TKI resistance had worse intracranial PFS and OS than TKI-naive patients.
Why this matters
- Whether EGFR-TKI resistance affects the efficacy of WBRT in patients with NSCLC with brain metastases is unknown.
- 344 patients with EGFR-mutated NSCLC and multiple brain metastases who were TKI-naive (n=207) or TKI-resistant (n=137).
- Funding: Wenzhou Science and Technology Bureau.
- 57.8% of patients had a Lung-molGPA score of 0-2.
- 42.2% had a score of 2.5-4.
- Overall, median PFS and OS did not differ significantly between the TKI-naive and TKI-resistant groups.
- In patients with Lung-molGPA 2.5-4, compared with the TKI-resistant group, TKI-naive patients had:
- Significantly longer median intracranial PFS (12.8 vs 10.1 months; P=.014).
- Significantly longer median OS (23.3 vs 15.3 months; P=.005).
- Results suggesting a benefit from undergoing WBRT before TKI treatment.
- Retrospective, single-center study.