Clinical outcome in patients with leptomeningeal metastasis from non-small cell lung cancer: Okayama Lung Cancer Study Group

Shigeki Umemura, Kazuya Tsubouchi, Hiroshige Yoshioka, Katsuyuki Hotta, Nagio Takigawa, Keiichi Fujiwara, Naokatsu Horita, Yoshihiko Segawa, Noboru Hamada, Ichiro Takata, Hiromichi Yamane, Haruhito Kamei, Katsuyuki Kiura, Mitsune Tanimoto

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Objective: We examined the prognosis of patients with leptomeningeal metastasis (LM) from non-small cell lung cancer (NSCLC) and that stratified by epidermal growth factor receptor (EGFR) mutation status in LM patients receiving EGFR-tyrosine kinase inhibitors (TKIs). Methods: We retrospectively analyzed a series of 91 consecutive NSCLC patients with LM between 2001 and 2010. Results: Most of the LM patients had adenocarcinoma histology and a poor performance status (PS). The median survival time (MST) for all patients was 3.6 months. Adenocarcinoma and TKI treatment were associated with a better prognosis. Among the patients, 51 received EGFR-TKIs. Of these, the EGFR mutation status was assessed in 30 patients; 7 (23%) showed no mutation (group 1), 10 (33%) had a mutation in exon 21 (group 2), and 13 (43%) had deletions in exon 19 (group 3). Interestingly, PS was significantly improved in groups 2 and 3 but not in group 1. The MST in these subgroups was 1.4, 7.1, and 11.0 months in groups 1, 2, and 3, respectively (p< 0.001). The median time to progression or symptom deterioration was 0.9, 2.0, and 7.8 months for groups 1, 2, and 3, respectively (p< 0.001). A multivariate analysis showed that EGFR-mutant tumors were associated with a better prognosis in patients receiving EGFR-TKIs. Conclusions: The prognosis for patients with LM from NSCLC was still poor. Survival after the initiation of EGFR-TKI treatment differed according to the type of EGFR mutation, suggesting the potential benefit of TKIs for patients with EGFR mutations, even though they suffered from LM.

Original languageEnglish
Pages (from-to)134-139
Number of pages6
JournalLung Cancer
Volume77
Issue number1
DOIs
Publication statusPublished - Jul 2012

Keywords

  • Epidermal growth factor receptor
  • Leptomeningeal metastasis
  • Lung cancer
  • Mutation
  • Non-small cell
  • Outcome
  • Tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

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