Thoracic CT radiomics analysis for predicting synchronous brain metastasis in patients with lung cancer

Several anaplastic lymphoma kinase inhibitors (ALKIs) have demonstrated excellent efficacy on overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and also better adverse effect (AE) profiles compared to cytotoxic chemotherapy in advanced stage anaplastic lymphoma kinase (ALK) rearrangement-positive non-small cell lung cancer (NSCLC) in phase III randomized clinical trials (RCTs). We conducted this systematic review and network meta-analysis to provide a ranking of ALKIs for treatment-naïve ALK-positive patients in terms of PFS, ORR, and AEs. In addition, a sub-group analysis of treatment benefits in patients with baseline brain metastasis was also conducted. Contrast-based analysis was performed for multiple treatment comparisons with the restricted maximum likelihood approach. Treatment rank was estimated using the surface under the cumulative ranking curve (SUCRA), as well as the probability of being the best (Prbest) reference. All next-generation ALKIs were superior to crizotinib in PFS but lorlatinib and brigatinib had increased AEs. The probability of lorlatinib being ranked first among all treatment arms was highest (SUCRA = 93.3%, Prbest = 71.8%), although there were no significant differences in pairwise comparisons with high- (600 mg twice daily) and low- (300 mg twice daily) dose alectinib. In subgroup analysis of patients with baseline brain metastasis, low-dose alectinib had the best PFS (SUCRA = 87.3%, Prbest = 74.9%). Lorlatinib was associated with the best ranking for ORR (SUCRA = 90.3%, Prbest = 71.3%), although there were no significant differences in pairwise comparisons with the other ALKIs. In addition, low-dose alectinib had the best safety performance (SUCRA = 99.4%, Prbest = 97.9%). Lorlatinib and low-dose alectinib had the best PFS and ORR in the overall population and baseline brain metastasis subgroup, respectively. Low-dose alectinib had the lowest AE risk among the available ALKIs. Further head-to-head large-scale phase III RCTs are needed to verify our conclusions.

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142P EGFR-TKI plus radiotherapy versus EGFR-TKI only in non-small cell lung cancer patients with brain metastasis: A systematic review and meta-analysis of observational studies

Journal of Thoracic Oncology ◽

10.1016/s1556-0864(21)01984-5 ◽

2021 ◽

Vol 16 (4) ◽

pp. S774

Author(s):

A. Tancherla ◽

F. Wijovi ◽

T.I. Hariyanto ◽

A. Kurniawan ◽

A. Giselvania

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Brain Metastasis ◽

Cancer Patients ◽

Observational Studies ◽

Meta Analysis ◽

Small Cell ◽

Small Cell Lung ◽

Lung Cancer Patients ◽

Egfr Tki

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Resection of a solitary brain metastasis in a patient with small cell lung cancer—Long-term survival

European Journal of Cancer ◽

10.1016/0959-8049(94)00491-m ◽

1995 ◽

Vol 31 (3) ◽

pp. 419 ◽

Cited By ~ 9

Author(s):

R.P. Abratt ◽

M. de Groot ◽

P.A. Willcox

Keyword(s):

Lung Cancer ◽

Brain Metastasis ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Small Cell Lung ◽

Term Survival ◽

Solitary Brain Metastasis ◽

Long Term Survival

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PCN96 Economic Burden of BRAIN Metastasis in NON SMALL CELL LUNG Cancer in South Korea: Nationwide Retrospective Cohort Study

Value in Health ◽

10.1016/j.jval.2020.08.233 ◽

2020 ◽

Vol 23 ◽

pp. S439

Author(s):

Y.B. Shim ◽

J.Y. Byun ◽

P. Mi-Hai

Keyword(s):

Lung Cancer ◽

Cohort Study ◽

Brain Metastasis ◽

South Korea ◽

Small Cell Lung Cancer ◽

Economic Burden ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Small Cell ◽

Small Cell Lung

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Rapid response of brain metastasis to crizotinib in a patient with KLC1-ALK fusion and MET gene amplification positive non-small cell lung cancer: a case report

Cancer Biology and Medicine ◽

10.20892/j.issn.2095-3941.2017.0017 ◽

2017 ◽

Vol 14 (2) ◽

pp. 183 ◽

Cited By ~ 10

Author(s):

Peng Wang ◽

Pei Xiao ◽

Yingnan Ye ◽

Pengpeng Liu ◽

Lei Han ◽

...

Keyword(s):

Lung Cancer ◽

Case Report ◽

Brain Metastasis ◽

Small Cell Lung Cancer ◽

Gene Amplification ◽

Cell Lung Cancer ◽

Small Cell ◽

Rapid Response ◽

Small Cell Lung

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Downregulation of MicroRNA-330 Correlates with the Radiation Sensitivity and Prognosis of Patients with Brain Metastasis from Lung Cancer

Cellular Physiology and Biochemistry ◽

10.1159/000479996 ◽

2017 ◽

Vol 42 (6) ◽

pp. 2220-2229 ◽

Cited By ~ 4

Author(s):

Li-Peng Jiang ◽

Zhi-Tu Zhu ◽

Yue Zhang ◽

Chun-Yan He

Keyword(s):

Lung Cancer ◽

Logistic Regression ◽

Radiation Therapy ◽

Survival Rate ◽

Brain Metastasis ◽

Cox Regression ◽

Radiation Sensitivity ◽

Extracranial Metastasis ◽

Radiation Resistant ◽

N Stage

Background: The present study sought to explore the role of microRNA-330 (miR-330) in predicting the radiation response and prognosis of patients with brain metastasis (BM) from lung cancer (LC). Methods: Patients with BM from LC were identified and classified into radiation-sensitive and radiation-resistant groups according to the overall survival rate, local and distant recurrence rate after conventional whole-brain radiation therapy. Quantitative realtime polymerase chain reaction (qRT-PCR) was used to detect miR-330 expression in serum. Receiver operating characteristic (ROC) curves were used to evaluate the prognostic value of miR-330 for the radiation sensitivity of brain metastasis from LC. Related clinical factors for radiation sensitivity were assessed by logistic regression analysis, and a survival analysis was conducted using COX regression and the Kaplan-Meier method. Results: MiR-330 exhibited lower expression in the radiation-sensitive group than in the radiation-resistant group. The area under the ROC curve of miR-330 for predicting radiation sensitivity was 0.898 (optimal cut-off value, 0.815), with a sensitivity of 71.7% and a specificity of 90.1%. After radiation therapy, patients with low miR-330 expression, compared to patients with high miR-330 expression, displayed a lower survival rate and a median survival time. MiR-330 expression was correlated with extracranial metastasis, maximum BM diameter, tumor-node-metastasis (TNM) stage and node (N) stage. Logistic regression and COX regression analyses revealed that extracranial metastasis, TNM stage, N stage and miR-330 expression were factors that influenced both radiation sensitivity and individual prognostic factors in patients with BM from LC. Conclusions: These findings indicate that the downregulation of miR-330 correlates with radiation sensitivity and poor prognosis in patients with BM from LC.

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OTHR-07. Systematic Review and Meta-analysis of Lung Cancer Brain Metastasis and Primary Tumor PD-L1 Expression Discordance

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab071.062 ◽

2021 ◽

Vol 3 (Supplement_3) ◽

pp. iii15-iii16

Author(s):

Raees Tonse ◽

Muni Rubens ◽

Haley Appel ◽

Martin C Tom ◽

Matthew D Hall ◽

...

Keyword(s):

Lung Cancer ◽

Systematic Review ◽

Brain Metastasis ◽

Tumor Cell ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Primary Tumor ◽

Small Cell ◽

Receptor Expression ◽

Small Cell Lung

Abstract Background Novel immunotherapeutic strategies, such as those targeting the PD-1/PD-L1 axis, are promising in patients with metastatic lung cancer and are often administered when tumors show PD-L1 positivity. The objective of this study was to analyze PD-L1 receptor discordance in tumor cell between the primary tumor and lung cancer brain metastasis (LCBM). Methods A systematic review of series published prior to April 2021 obtained from the Medline database of biopsied or resected LCBM evaluating PD-L1 discordance was performed using PRISMA guidelines. Weighted random effects models were used to calculate pooled estimates. Results Six full-text articles (n=247 patients) with a median of 32 patients in each study (range: 24–73 patients) reported PD-L1 receptor expression analyses of both primary lung tumors and brain metastases. The majority of patients (81%) were smokers, with 67% non-small cell lung cancer and 33% small cell lung cancer. The pooled estimate for overall PD-LI receptor concordance between primary and LCBM was 76% (95% CI: 52%-90). The positivity rate varied when analyzed by various cutoff levels of PD-L1 expression; for <1% expression, it was 41% (95% CI: 22%-62%) for primary vs. 58% (95% CI: 35%-78%) for LCBM; for PD-L1 expression of 1–50%, it was 24% (95% CI: 13%-40%) vs. 19% (95% CI: 10%-33%); and for PD-L1 >50% it was 12% (95% CI: 4%-33%) vs. 21% (95% CI: 14%-29%) (p=0.425). The pooled estimate for overall PD-LI receptor discordance between primary and LCBM was 17% (95% CI: 10%-27%). Meta-regression analysis showed that age, sex, smoking status, and histology were not associated with PD-LI receptor discordance. Conclusions PD-L1 status discordance in tumor cell occurs in approximately 20% of LCBM, with the greatest discordance in the <1% expression category. Awareness of this discordance is important for the selection of immune checkpoint inhibitor therapy as well as in the analysis of patterns of failures.

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