Effects of tyrosine kinase inhibitors in treatment of non small cell lung cancer patients with brain metastases, real world experience.

Abstract

Background: Lung cancer remains one of the leading causes of cancer-related mortality worldwide, and brain metastases are a common and serious complication of advanced disease. Early detection and effective management of brain metastases are essential for improving survival and maintaining quality of life. Recent advances in targeted therapies, particularly tyrosine kinase inhibitors (TKIs), have shown promising efficacy in controlling both systemic and intracranial disease. This study aimed to evaluate the efficacy of TKIs in patients with non-small cell lung cancer (NSCLC) harboring driver mutations and presenting with brain metastases.

Materials and methods: We retrospectively analyzed 31 patients with NSCLC and brain metastases who received targeted therapy at Karadeniz Technical University Faculty of Medicine between January 1, 2010, and September 1, 2023. Clinical and demographic data, including age, sex, histological and molecular subtypes, metastatic sites, progression-free survival (PFS), overall survival (OS), and treatment modalities, were evaluated.

Results: Median OS was 34.5 months in patients with PD-L1 expression < 50%, compared with 4.5 months in those with PD-L1 expression ≥ 50% (p = 0.004). Median OS was 36.1 months (range, 1.8-58.7) among never-smokers and 4.5 months (range, 2.2-18.5) among current or former smokers (p = 0.005).

Conclusion: TKIs remain an effective treatment option for patients with NSCLC and brain metastases. PD-L1 expression and smoking status may influence clinical outcomes. Further studies are warranted to validate these findings and clarify the prognostic role of PD-L1 expression in NSCLC patients with brain metastases.