Bevacizumab improved prognosis for advanced EGFR-mutant lung adenocarcinoma with brain metastasis receiving cerebral radiotherapy

Yuanliang Zhou; Jingchao Li; Yankang Li; Guangchuan Deng; Qi Wang; Hongyue Qin; Jianbin Li; Zhenxiang Li

doi:10.1007/s12094-024-03418-3

Bevacizumab improved prognosis for advanced EGFR-mutant lung adenocarcinoma with brain metastasis receiving cerebral radiotherapy

Clin Transl Oncol. 2024 Mar 13. doi: 10.1007/s12094-024-03418-3. Online ahead of print.

Authors

Yuanliang Zhou^{1

2}, Jingchao Li³, Yankang Li², Guangchuan Deng^{1

2}, Qi Wang^{1

2}, Hongyue Qin^{1

2}, Jianbin Li^{4

5}, Zhenxiang Li⁶

Affiliations

¹ Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China.
² Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, People's Republic of China.
³ The People's Hospital of Zhangqiu Area, Jinan, People's Republic of China.
⁴ Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, People's Republic of China. lijianbin@msn.com.
⁵ Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, People's Republic of China. lijianbin@msn.com.
⁶ Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117, People's Republic of China. Lizx0108@163.com.

PMID: 38478262
DOI: 10.1007/s12094-024-03418-3

Abstract

Objective: This study aimed to determine whether the combined use of bevacizumab could improve overall survival (OS) in patients with brain metastasis (BM), epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) undergoing cerebral radiotherapy.

Materials and methods: A total of 237 patients with EGFR-mutant lung adenocarcinoma and BM met the inclusion criteria for this retrospective study, including 102 patients in the bevacizumab treatment group and 135 in the non-bevacizumab group. The Kaplan-Meier method was used for survival analysis. Univariate and multivariate analyses were performed to identify EGFR-mutated BM prognostic factors for these patients.

Results: At the end of the last follow-up period, 176 patients (74.3%) had died, and the median overall survival (OS) was 34.2 months. We observed a significant difference in the median OS between the bevacizumab and non-bevacizumab groups (45.8 months vs 30.0 months, P < 0.0001). Among the 178 (75.1%) patients who received cerebral radiotherapy, the median OS of patients in the bevacizumab + cerebral radiotherapy group was 45.8 months versus 32.0 months in the non-bevacizumab + cerebral radiotherapy group, respectively (P = 0.0007). Patients treated with bevacizumab after cerebral radiotherapy had a longer median OS than patients treated with bevacizumab before cerebral radiotherapy (59.4 months vs 33.7 months, P = 0.0198). In the univariate analysis, smoking status, Lung-molGPA scores, and bevacizumab therapy showed correlations (HR = 1.450, P = 0.045; HR = 0.700, P = 0.023; HR = 0.499, P < 0.001). Multivariate analysis showed that bevacizumab therapy alone (hazard ratio [HR] = 0.514; P < 0.001) was independently associated with improved OS.

Conclusion: In patients with BM from EGFR-mutated NSCLC, cerebral radiotherapy with bevacizumab markedly improved OS. This improvement was more evident after cerebral radiotherapy.

Keywords: Bevacizumab; Brain metastasis; Cerebral radiotherapy; Non-small cell lung cancer; Overall survival.

Abstract

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