ALK and brain mets

A study entitled “Extened Survival and Prognostic Factors for Patients With ALK-Rearranged Non-Small-Cell lung Cancer and Brain Metastasis” was published online October 5, 2015 in the Journal of Clinical Oncology. The lead author was Joseph N. Contessa from Yale.

The study was done across six institutions and involved 90 patients: 84 got radiotherapy and 86 recieved tyrosine kinase inhibitor (TKI) therapy (presumably one or more ALK inhibitors).

Median overall survival after development of brain mets was 50 months and median intracranial progression free survival was 12 months.

Three positive prognosticators were 1) absence of extracranial mets, 2) Karnofsky score greater than or equal to 90, and 3) no history of TKIs before brain mets developed.  The researchers stratified the patients into four groups 1) none, 2) one 3) two, or 4) all three of the positive prognosticators. The results were that the 2 year survival rate for each group was 1) 33%, 2) 59%, 3) 76%, and 4) 100% respectively.

Factors that were not prognosticators were treatment with stereo static radiosurgery (SRS) vs. whole brain radiation (WBR). Thus they recommended using SRS initially and primarily.

A copy of the full article is $30.

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