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• W2890950995 abstract "9081 Background: HER2 mutations are oncogenic drivers in 3% of lung cancers. Here we describe the frequency and course of patients with HER2 mutant lung cancers with spread to brain and compare results to individuals with KRAS- and EGFR-driven cancers. Methods: We compared cohorts of consecutive patients with HER2-(n = 98), KRAS- (n = 200) and EGFR- (n = 200) mutant lung cancers. Multivariate logistical regressions adjusted for follow-up length were performed to evaluate baseline and subsequent development of brain metastases and survival from the date of diagnosis of stage IV disease. Results: In total, brain metastases occurred in 41% of 498 patients (95% CI 37 to 45%). At diagnosis of stage IV disease, 19% (19/98) in the HER2 cohort, 24% (48/200) in KRAS, and 31% (62/200) in EGFR had brain metastases (p= 0.8). Among those without brain metastases at baseline, 34% (27/79) of patients with HER2 vs 11% (16/152) with KRAS (p < 0.001), vs 23% (32/138) with EGFR (p= 0.048) developed brain metastases during treatment. The overall incidence of brain metastases was 47% (46/98) in patients with HER2, 32% (64/200) with KRAS), and 47% (94/200) with EGFR (p = 0.73). The occurrence of any brain metastases imparted a shorter median survival in patients with HER2- (25 vs 30 months, p< 0.001) and EGFR- (29 vs 92 months, p < 0.001) driven cancers but not with KRAS (14 vs 21 months, p= 0.44). The median overall survival was 1.6 years (range 1.3 – 2.2 years) for HER2, 1.1years (range 0.8 – 1.3 years) for KRAS, and 3.0 years (range 2.5 – 4.0 years) for EGFR (p< 0.0001). Conclusions: In our patients with lung cancers driven by HER2, KRAS, and EGFR, brain metastases occurred in 41% overall. The risk is numerically higher with HER2 and EGFR than KRAS. While the incidence of brain metastases in patients with HER2 mutant lung cancers is numerically lower than EGFR at diagnosis, it rises over the disease course to 47%, equal that of EGFR. Among those without brain metastases at baseline, a greater number of patients with HER2-mutant tumors subsequenty developed brain metastases during treatment compared to the EGFR and KRAS cohorts. With one third of patients with HER2 mutant lung cancers developing brain metastases during treatment, close surveillance is critical." @default.
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• W2890950995 date "2018-05-20" @default.
• W2890950995 modified "2023-09-26" @default.
• W2890950995 title "Frequency of brain metastases and outcomes in patients with <i>HER2-, KRAS-, and EGFR</i>-mutant lung cancers." @default.
• W2890950995 doi "https://doi.org/10.1200/jco.2018.36.15_suppl.9081" @default.
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