211P First analysis of a real-world study to explore the character and treatment outcome of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) on non-small cell lung cancer (NSCLC) with brain metastases (BM)

Background: Lung Cancer is the most common cancer in China. Brain metastasis(BM) is the main reason for treatment failure of advanced lung cancer and treatment strategy is unclear in real world practice. Recently, some data showed that EGFR-TKI was an efficient option for NSCLC BM patients. Further evidence on EGFR-TKI plus standard therapy in clinical practice is highly expected. Methods: Based on our clinical database, we collected the clinical data of patients diagnosed with NSCLC and BM during 2014 and 2017. The therapeutic effectiveness was compared between the chemoradiation and chemoradiation + EGFR-TKI. Log-rank test was used in the comparison of the two groups. Cox's proportional hazard models were used in the factor analyses. Results: Total 153 patients were analyzed in the study, 61 patients treated by chemoradiation and 92 patients by chemoradiation + EGFR-TKI. Baseline characters of age, location and T stage of primary disease, and metastatic numbers were balanced in two groups. Gefitinib is the most frequently used TKI in clinical practice, composing about 48%(44/92). In chemoradiation + EGFR-TKI, 72 patients were performed with EGFR gene test and of them, 56 patients (78%) were EGFR positive. In chemoradiation, 29 patients were performed with EGFR gene test and 2 patients (6.9%) were EGFR positive. EGFR positive rate was 57% (58/101) in the total patients. The OS trend obviously showed that patients got more advantage from chemoradiation + EGFR-TKI compared with chemoradiation. Median OS was 27.0 months in the chemoradiation + EGFR-TKI and 16.6 months in the chemoradiation. Subgroup 24 months survival rate analysis of Gefitinib vs other TKI is 0.732 and 0.427, p = 0.0124. This preliminary analysis indicated that adding TKI to chemoradiation treatment could improve OS (hazard ratio [HR] 1.887) on NSCLC BM patients. Conclusions: The first analysis presents the survival benefit of EGFR-TKI plus standard treatment on NSCLC BM patients. Further data from this real-world study will be generated as we continue recruiting more patients in near future. Legal entity responsible for the study: Oncology Department, Tangdu Hospital affiliated with the PLA Airforce Medical University Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest.