J Thorac Oncol: The efficacy of CNS-permeable TKI monotherapy vs TKI+radiotherapy in the treatment of patients with EGFR/ALK-positive NSCLC brain metastases

The treatment of central nervous system (CNS) metastasis in patients with non-small cell lung cancer ( NSCLC ) with driver gene mutations has traditionally used tyrosine kinase inhibitors (TKIs) and intracranial radiotherapy

The treatment of central nervous system (CNS) metastasis in patients with non-small cell lung cancer ( NSCLC ) with driver gene mutations has traditionally used tyrosine kinase inhibitors (TKIs) and intracranial radiotherapy

The study is divided into two groups: TKI monotherapy and TKI+radiotherapy (TKI+CNS RT)

The study is divided into two groups: TKI monotherapy and TKI+radiotherapy (TKI+CNS RT)

A total of 147 patients were enrolled (EGFR=94 cases, ALK=52 cases, 1 case in both groups)

In EGFR-positive patients, there was no statistical difference in the prognostic indicators between the TKI vs CNS RT + TKI group, including the time to any progression (8.

Prognosis of EGFR population

In ALK-positive patients, there was no statistical difference in the prognostic indicators between the TKI vs CNS RT + TKI group, including the time of any progression (11.

In ALK-positive patients, there was no statistical difference in the prognostic indicators between the TKI vs CNS RT + TKI group, including the time of any progression (11.

Prognosis of ALK population

For EGFR-positive patients, there was no statistical difference in the time to treatment failure between the two treatment groups (13.

For EGFR-positive patients, there was no statistical difference in the time to treatment failure between the two treatment groups (13.

EGFR and ALK population treatment failure time

Subgroup analysis found that when TKI was used as the first-line treatment, there was no statistical difference between the two treatment groups of EGFR-positive patients, including any progression time (11.

Subgroup analysis found that when TKI was used as the first-line treatment, there was no statistical difference between the two treatment groups of EGFR-positive patients, including any progression time (11.

In summary, the study shows that CNS-permeable TKI therapy can delay the use of radiotherapy in suitable patients without adverse effects

Original source:

Thomas NJ, Myall NJ, Sun F, et al.
Brain Metastases in EGFR- and ALK-positive Non-Small Cell Lung Cancer: Outcomes of CNS Penetrant Tyrosine Kinase Inhibitors (TKIs) Alone versus in Combination with Radiation.
J Thorac Oncol.
2021 Aug 26:S1556-0864(21)02401-1.
doi: 10.
1016/j.
jtho.
2021.
08.
009.
Epub ahead of print.
PMID: 34455066.

Thomas NJ, Myall NJ, Sun F, et al.
Brain Metastases in EGFR- and ALK-positive Non-Small Cell Lung Cancer: Outcomes of CNS Penetrant Tyrosine Kinase Inhibitors (TKIs) Alone versus in Combination with Radiation.
J Thorac Oncol.
2021 Aug 26:S1556-0864(21)02401-1.
doi: 10.
1016/j.
jtho.
2021.
08.
009.
Epub ahead of print.
PMID: 34455066.


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