Epidermal growth factor receptor mutation and pattern of brain metastasis in patients with non-small cell lung cancer.

BACKGROUND/AIMS: We investigated the time taken for patients with metastatic non-small cell lung cancer (NSCLC) to develop brain metastases (BM), as well as their subsequent overall median survival following diagnosis, considering the epidermal growth factor receptor () mutational status.

METHODS

We retrospectively investigated the medical records of 259 patients diagnosed with advanced NSCLC from January 2010 to August 2013, who were tested for mutations. The time from the diagnosis of advanced NSCLC to the development of BM and the overall median survival after BM development (BM-OS) were evaluated and compared by mutational status.

RESULTS

Sixty-seven patients (25.9%) developed BM. Synchronous BM occurred more often in patients with mutation type (MT) (n = 20, 27.4%) compared with wild type (WT) (n = 27, 14.5%, < 0.009). The median BM-OS was significantly longer in patients with MT than in those with WT (25.7 months vs. 3.8 months, < 0.001), and a similar trend was noticed for patients with synchronous BM (25.7 months for MT vs. 6.8 months for WT, < 0.001). However, in patients with metachronous BM development, the difference in BM-OS between patients with MT (14.6 months) and WT (2.5 months) did not reach statistical significance ( = 0.230).

CONCLUSIONS

Synchronous BM was more common in NSCLC patients with MT than in those with WT. However, mutations were associated with significantly longer median BM-OS, especially when the brain was the first metastatic site.