![]() This allowed us to evaluate potential differences among first-line treatments for EGFRm + NSCLC patients with BMs and provide a useful reference source for effective future clinical applications. The patients may or may not have received brain radiotherapy. ![]() In this real-world clinical study, systemic and local treatment outcomes of patients with BMs were retrospectively analyzed focusing on EGFRm + NSCLC combined with BMs cases and included 1st generation EGFR-TKI treatment alone and 1st generation EGFR-TKI plus chemotherapy or anti-angiogenesis drugs. Therefore, the best first-line therapy for EGFRm + NSCLC with BMs has yet to be unequivocally established. It is noteworthy that most NSCLC patients with BMs are not usually included in clinical trials. Although third-generation tyrosine kinase inhibitors (TKIs) that target EGFR have enhanced central nervous system (CNS) permeability and show better CNS efficacy in patients compared to first-generation EGFR-TKIs, the limited treatment options after drug resistance highlights the urgent need for alternative treatment strategies for patients with BMs. The percentage of patients diagnosed with advanced NSCLC and BMs is about 25–30% on first diagnosis and a further 40–50% develop BMs during the subsequent course of the disease. About 70% of EGFRm+ NSCLC patients develop brain metastases (BMs), compared to an incidence of 38% of NSCLC cases without an EGFR wild-type mutation. According to the PIONEER study, from 372 Chinese NSLC EGFRm + patients, 346 had EGFR activating mutations, with 182 exon 19 deletions and 169 L858R point mutations being the most common mutation types. In China the prevalence of EGFRm + NSCLC cases has been estimated to be 36.5–40.3%. Epidermal growth factor receptor ( EGFR) mutations, are known oncogenic drivers in NSCLC patients and east Asian individuals with NSCLC had a substantially greater EGFR mutant (m +) prevalence than Caucasian patients (about 30% vs. Non-small cell lung cancer (NSCLC) patients have unacceptable morbidity and mortality rates, with only 15% surviving for up to 5 years after diagnosis. The therapy improved the control and delayed progression of intracranial lesions and prolonged survival times. Conclusionsįirst-generation EGFR-TKI + bevacizumab treatment outperformed other regimens in EGFRm + NSCLC patients with brain metastasis. Most patients suffered grade 1–2 treatment-related adverse events, which were relieved soon after symptomatic treatment. Significant difference was found in intracranial ORR between groups A + B vs. Median OS in groups A and B were 27.9 m and 24.4 m, respectively, while groups C and D have not yet achieved median OS. Extracranial PFS were longer in group B in comparison with group A (13.0 m vs. Intracranial PFS of groups C + D was longer than for groups A + B (18.9 m vs. Intracranial and extracranial progression-free survival (PFS), the overall survival (OS), objective remission rates (ORRs) and adverse events were analyzed. In this retrospective study, 172 EGFRm + patients with advanced NSCLC who received a 1st generation EGFR tyrosine kinase inhibitor (TKI) were divided into 4 groups: A, EGFR-TKI (n = 84) B, EGFR-TKI + pemetrexed + cisplatin/carboplatin chemotherapy (CT) (n = 55) C, EGFR-TKI + bevacizumab (n = 15) and D, EGFR-TKI + pemetrexed + cisplatin/carboplatin CT + bevacizumab (n = 18). The aims of the study were to evaluate potential differences among first-line treatment for EGFR mutant (m+) non-small cell lung cancer (NSCLC) patients with brain metastasis in China and to identify the factors influencing survival outcomes.
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