2019 ASCO Annual Meeting!
Session: Lung Cancer—Non-Small Cell Metastatic
Type: Poster Session
Time: Sunday June 2, 8:00 AM to 11:00 AM
Location: Hall A
A comparative analysis of survival in patients with non-small cell lung cancer with brain metastases receiving intracranial radiation with and without immunotherapy.
Metastatic Non-Small Cell Lung Cancer
Lung Cancer—Non-Small Cell Metastatic
2019 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #348)
J Clin Oncol 37, 2019 (suppl; abstr 9025)
Author(s): Sunita Patruni, Ahmed Khattab, Stephen Abel, Shaakir Hasan, Saleha Rizwan, Gene Grant Finley, Dulabh K. Monga, Vivek Verma, Rodney E Wegner; Allegheny Health Network, Pittsburgh, PA; Department of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA; AHN, Pittsburgh, PA; Allegheny Health Network Cancer Institute, Pittsburgh, PA; Medical Oncology, Allegheny Health Network, Pittsburgh, PA; Division of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA
Background: Many patients diagnosed with advanced non-small cell lung cancer (NSCLC) will develop intracranial metastasis, contributing significantly to morbidity and mortality. Immunotherapy (IMT) has emerged as the standard of care in select cases of metastatic NSCLC, though data investigating the survival impact of IMT and radiation (XRT) in these patients is limited. To characterize the survival impact of intracranial XRT and IMT in NSCLC patients with brain metastasis, we analyzed the National Cancer Database (NCDB). Methods: We queried the NCDB for patients with metastatic NSCLC having brain metastasis receiving intracranial XRT ± IMT. Univariable and multivariable analyses identified characteristics predictive of overall survival. Cox proportional hazard ratios with propensity matching mitigated indication bias between the two arms. Results: 13,998 NSCLC patients who received IMT (n = 545) or did not receive IMT (n = 13,545) were eligible for analysis. Univariable analysis demonstrated a median overall survival of 13.1 months (95% CI: 11.8-15.0) vs. 9.7 months (95% CI: 9.5-9.9) (p < 0.0001) and 3-year overall survival of 17% vs. 12% [p < 0.0001; HR: 0.77 (0.71-0.84)] in patients receiving and not receiving IMT respectively. Patients with N3 disease and those diagnosed between 2012 and 2014 were more likely to have received IMT. Receipt of IMT remained an independent predictor of increased survival on propensity score matched multivariable comparison (p = 0.0002). Conclusions: Receipt of IMT was an independent predictor of increased overall survival in patients with NSCLC having intracranial metastasis. Randomized, prospective studies are needed to further validate these findings.
|Characteristic||Hazard of Death (95% CI)||p|
|Cox Model with Propensity Score|
|1.28 (1.21-1.36)||< 0.0001|