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25-03-2024 | NSCLC | Research

Utility of molecular markers in predicting local control specific to lung cancer spine metastases treated with stereotactic body radiotherapy

Authors: Dana Shor, Alexander V. Louie, Kang Liang Zeng, Ines B. Menjak, Eshetu G. Atenafu, Chia-Lin Tseng, Jay Detsky, Jeremie Larouche, Beibei Zhang, Hany Soliman, Sten Myrehaug, Pejman Maralani, David M. Hwang, Arjun Sahgal, Hanbo Chen

Published in: Journal of Neuro-Oncology | Issue 2/2024

Abstract

Background and purpose

We report outcomes following spine stereotactic body radiotherapy (SBRT) in metastatic non-small cell lung cancer (NSCLC) and the significance of programmed death-ligand 1 (PD-L1) status, epidermal growth factor receptor (EGFR) mutation and timing of immune check point inhibitors (ICI) on local failure (LF).

Materials and methods

165 patients and 389 spinal segments were retrospectively reviewed from 2009 to 2021. Baseline patient characteristics, treatment and outcomes were abstracted. Primary endpoint was LF and secondary, overall survival (OS) and vertebral compression fracture (VCF). Multivariable analysis (MVA) evaluated factors predictive of LF and VCF.

Results

The median follow-up and OS were: 13.0 months (range, 0.5–95.3 months) and 18.4 months (95% CI 11.4–24.6). 52.1% were male and 76.4% had adenocarcinoma. Of the 389 segments, 30.3% harboured an EGFR mutation and 17.0% were PD-L1 ≥ 50%. The 24 months LF rate in PD-L1 ≥ 50% vs PD-L1 < 50% was 10.7% vs. 38.0%, and in EGFR-positive vs. negative was 18.1% vs. 30.0%. On MVA, PD-L1 status of ≥ 50% (HR 0.32, 95% CI 0.15–0.69, p = 0.004) significantly predicted for lower LF compared to PD-L1 < 50%. Lower LF trend was seen with ICI administration peri and post SBRT (HR 0.41, 95% CI 0.16–1.05, p = 0.062). On MVA, polymetastatic disease (HR 3.28, 95% CI 1.84–5.85, p < 0.0001) and ECOG ≥ 2 (HR 1.87, 95% CI 1.16–3.02, p = 0.011) significantly predicted for worse OS and absence of baseline VCF predicted for lower VCF rate (HR 0.20, 95% CI 0.10–0.39, p < 0.0001).

Conclusion

We report a significant association of PD-L1 ≥ 50% status on improved LC rates from spine SBRT in NSCLC patients.

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Title: Utility of molecular markers in predicting local control specific to lung cancer spine metastases treated with stereotactic body radiotherapy
Authors: Dana Shor
Alexander V. Louie
Kang Liang Zeng
Ines B. Menjak
Eshetu G. Atenafu
Chia-Lin Tseng
Jay Detsky
Jeremie Larouche
Beibei Zhang
Hany Soliman
Sten Myrehaug
Pejman Maralani
David M. Hwang
Arjun Sahgal
Hanbo Chen
Publication date: 25-03-2024
Publisher: Springer US
Keywords: NSCLC
NSCLC
Metastasis
Radiotherapy
Tyrosine Kinase Inhibitors
Tyrosine Kinase Inhibitors
Lung Cancer
Lung Cancer
Lung Cancer
Published in: Journal of Neuro-Oncology / Issue 2/2024
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-024-04603-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Utility of molecular markers in predicting local control specific to lung cancer spine metastases treated with stereotactic body radiotherapy

Abstract

Background and purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Materials and methods

Results

Conclusion

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