Examining the Effect of ALK and EGFR Mutations on Survival Outcomes in Surgical Lung Brain Metastasis Patients

• Type of Material: Article
• Authors: Sneha Sai Mannam, University of Pennsylvania; David P. Bray, Thomas Jefferson University; Chibueze D. Nwagwu, Brigham & Women's Hospital; Jim Zhong, Emory University; Hui-Kuo Shu, Emory University; Bree Eaton, Emory University; Lisa Sudmeier, Emory University; Subir Goyal, Emory University; Christopher Deibert, Emory University; Edjah Nduom, Emory University; Jeffrey Olson, Emory University; Kimberly Hoang, Emory University
• Language: English
• Date: 2023-10-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2023 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/cancers15194773
• Title of Journal or Parent Work: CANCERS
• Volume: 15
• Issue: 19
• Grant/Funding Information: David P. Bray is partly supported by the Nell W. and William S. Elkin Research Fellowship in Oncology, Winship Cancer Institute, Emory University Hospital, Atlanta, GA, and supported in part by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002378 and TL1TR002382. Kimberly Hoang acknowledges funding from the Jordan Family Brain Tumor Initiative and Donaldson Research Synergy Fund. Research reported in this publication was supported in part by the Biostatistics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: CHEMOTHERAPY; Life Sciences & Biomedicine; RETROSPECTIVE ANALYSIS; TRASTUZUMAB; brain metastases; lung cancer; MANAGEMENT; Science & Technology; anaplastic lymphoma kinase; GENOMIC CHARACTERIZATION; STEREOTACTIC RADIOSURGERY; radiosurgery; systemic therapies; epidermal growth factor receptor; MELANOMA; OPEN-LABEL; Oncology; CANCER; PROGNOSTIC-FACTORS
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Rehabilitation and Therapy; Health Sciences, Oncology

Abstract

In the context of the post-genomic era, where targeted oncological therapies like monoclonal antibodies (mAbs) and tyrosine-kinase inhibitors (TKIs) are gaining prominence, this study investigates whether these therapies can enhance survival for lung carcinoma patients with specific genetic mutations—EGFR-amplified and ALK-rearranged mutations. Prior to this study, no research series had explored how these mutations influence patient survival in cases of surgical lung brain metastases (BMs). Through a multi-site retrospective analysis, the study examined patients who underwent surgical resection for BM arising from primary lung cancer at Emory University Hospital from January 2012 to May 2022. The mutational statuses were determined from brain tissue biopsies, and survival analyses were conducted. Results from 95 patients (average age: 65.8 ± 10.6) showed that while 6.3% had anaplastic lymphoma kinase (ALK)-rearranged mutations and 20.0% had epidermal growth factor receptor (EGFR)-amplified mutations—with 9.5% receiving second-line therapies—these mutations did not significantly correlate with overall survival. Although the sample size of patients receiving targeted therapies was limited, the study highlighted improved overall survival and progression-free survival rates compared to earlier trials, suggesting advancements in systemic lung metastasis treatment. The study suggests that as more targeted therapies emerge, the prospects for increased overall survival and progression-free survival in lung brain metastasis patients will likely improve.