Scientific Reports (Mar 2024)
Treatment outcomes and prognostic factors in patients with driver mutant non-small cell lung cancer and de novo brain metastases
- Seda Kahraman,
- Serdar Karakaya,
- Muhammed Ali Kaplan,
- Sema Sezgin Goksu,
- Akin Ozturk,
- Zehra Sucuoglu Isleyen,
- Jamshid Hamdard,
- Sedat Yildirim,
- Tolga Dogan,
- Selver Isik,
- Abdussamet Celebi,
- Burcu Belen Gulbagci,
- Nail Paksoy,
- Mutlu Dogan,
- Haci Mehmet Turk,
- Ahmet Bilici,
- Ali Murat Tatli,
- Sinem Akbas,
- Nedim Turan,
- Ilhan Hacibekiroglu,
- Gamze Gokoz Dogu,
- Adnan Aydiner,
- Ahmet Taner Sumbul,
- Serap Akyurek,
- Merih Yalciner,
- Ahmet Demirkazik,
- Pinar Gursoy,
- Musa Baris Aykan,
- Elif Sahin,
- İbrahim Karadag,
- Osman Kostek,
- Muhammed Muhiddin Er,
- Mehmet Artaç,
- Yakup Duzkopru,
- Dincer Aydin,
- Deniz Isik,
- Yusuf Karakas,
- Saadettin Kilickap,
- Cihan Erol,
- Bilgin Demir,
- Burak Civelek,
- Yakup Ergun,
- Muhammed Bulent Akinci,
- Izzet Dogan,
- Nuri Karadurmus,
- Perran Fulden Yumuk,
- Mehmet Ali Nahit Sendur
Affiliations
- Seda Kahraman
- Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University
- Serdar Karakaya
- Department of Medical Oncology, Ankara Ataturk Sanatoryum Training and Research Hospital
- Muhammed Ali Kaplan
- Department of Medical Oncology, Dicle University Medical Faculty Hospital
- Sema Sezgin Goksu
- Department of Medical Oncology, Akdeniz University Hospital
- Akin Ozturk
- Department of Medical Oncology, Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital
- Zehra Sucuoglu Isleyen
- Department of Medical Oncology, Faculty of Medicine Hospital, Bezmialem Vakif University
- Jamshid Hamdard
- Department of Medical Oncology, Medipol University Hospital
- Sedat Yildirim
- Department of Medical Oncology, Kartal Dr. Lutfi Kirdar City Hospital
- Tolga Dogan
- Department of Medical Oncology, Pamukkale University Medical Faculty Hospital
- Selver Isik
- Department of Medical Oncology, Marmara University Pendik Training and Research Hospital
- Abdussamet Celebi
- Department of Medical Oncology, Marmara University Pendik Training and Research Hospital
- Burcu Belen Gulbagci
- Department of Medical Oncology, Sakarya University School of Medicine
- Nail Paksoy
- Department of Medical Oncology, Istanbul Faculty of Medicine, Istanbul University
- Mutlu Dogan
- Department of Medical Oncology, Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital
- Haci Mehmet Turk
- Department of Medical Oncology, Faculty of Medicine Hospital, Bezmialem Vakif University
- Ahmet Bilici
- Department of Medical Oncology, Medipol University Hospital
- Ali Murat Tatli
- Department of Medical Oncology, Akdeniz University Hospital
- Sinem Akbas
- Department of Medical Oncology, Koç University Medical Faculty Hospital
- Nedim Turan
- Department of Medical Oncology, Kartal Dr. Lutfi Kirdar City Hospital
- Ilhan Hacibekiroglu
- Department of Medical Oncology, Sakarya University School of Medicine
- Gamze Gokoz Dogu
- Department of Medical Oncology, Pamukkale University Medical Faculty Hospital
- Adnan Aydiner
- Department of Medical Oncology, Istanbul Faculty of Medicine, Istanbul University
- Ahmet Taner Sumbul
- Department of Medical Oncology, Baskent University Adana Dr. Turgut Noyan Application and Research Center
- Serap Akyurek
- Department of Radiation Oncology, Faculty of Medicine, Ankara University
- Merih Yalciner
- Department of Medical Oncology, Faculty of Medicine, Ankara University
- Ahmet Demirkazik
- Department of Medical Oncology, Faculty of Medicine, Ankara University
- Pinar Gursoy
- Department of Medical Oncology, Ege University Medical Faculty Hospital
- Musa Baris Aykan
- Department of Medical Oncology, Gulhane Training and Research Hospital
- Elif Sahin
- Department of Medical Oncology, Kocaeli University Medical Faculty Hospital
- İbrahim Karadag
- Department of Medical Oncology, Hittite University Corum Training and Research Hospital
- Osman Kostek
- Department of Medical Oncology, Marmara University Pendik Training and Research Hospital
- Muhammed Muhiddin Er
- Department Of Medical Oncology, Necmettin Erbakan University Meram Medical Faculty Hospital
- Mehmet Artaç
- Department Of Medical Oncology, Necmettin Erbakan University Meram Medical Faculty Hospital
- Yakup Duzkopru
- Department of Medical Oncology, Ankara Etlik City Hospital
- Dincer Aydin
- Department of Medical Oncology, Kocaeli Derince Training and Research Hospital
- Deniz Isik
- Department of Medical Oncology, Kocaeli Medical Park Hospital
- Yusuf Karakas
- Department of Medical Oncology, Acıbadem Bodrum Hospital
- Saadettin Kilickap
- Department of Medical Oncology, Liv Hospital, Istinye University
- Cihan Erol
- Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University
- Bilgin Demir
- Department of Medical Oncology, Aydin Ataturk State Hospital
- Burak Civelek
- Department of Medical Oncology, Ankara Bilkent City Hospital
- Yakup Ergun
- Department of Medical Oncology, Batman Training and Research Hospital
- Muhammed Bulent Akinci
- Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University
- Izzet Dogan
- Department of Medical Oncology, Basaksehir Cam and Sakura City Hospital
- Nuri Karadurmus
- Department of Medical Oncology, Gulhane Training and Research Hospital
- Perran Fulden Yumuk
- Department of Medical Oncology, Koç University Medical Faculty Hospital
- Mehmet Ali Nahit Sendur
- Department of Medical Oncology, Ankara Bilkent City Hospital, Ankara Yildirim Beyazit University
- DOI
- https://doi.org/10.1038/s41598-024-56046-w
- Journal volume & issue
-
Vol. 14,
no. 1
pp. 1 – 13
Abstract
Abstract Central nervous system (CNS) metastases can be seen at a rate of 30% in advanced stages for patients with non-small cell lung cancer (NSCLC). Growing evidence indicates the predictive roles of driver gene mutations in the development of brain metastases (BM) in recent years, meaning that oncogene-driven NSCLC have a high incidence of BM at diagnosis. Today, 3rd generation targeted drugs with high intracranial efficacy, which can cross the blood–brain barrier, have made a positive contribution to survival for these patients with an increased propensity to BM. It is important to update the clinical and pathological factors reflected in the survival with real-life data. A multi-center, retrospective database of 306 patients diagnosed with driver mutant NSCLC and initially presented with BM between between November 2008 and September 2022 were analyzed. The median progression-free survival (mPFS) was 12.25 months (95% CI, 10–14.5). While 254 of the patients received tyrosine kinase inhibitor (TKI), 51 patients received chemotherapy as first line treatment. The median intracranial PFS (iPFS) was 18.5 months (95% CI, 14.8–22.2). The median overall survival (OS) was 29 months (95% CI, 25.2–33.0). It was found that having 3 or less BM and absence of extracranial metastases were significantly associated with better mOS and iPFS. The relationship between the size of BM and survival was found to be non-significant. Among patients with advanced NSCLC with de novo BM carrying a driver mutation, long-term progression-free and overall survival can be achieved with the advent of targeted agents with high CNS efficacy with more conservative and localized radiotherapy modalities.
Keywords
- Oncogene-driven advanced non-small cell lung cancer
- De novo brain metastases
- Survival related parameters
