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Clinical characteristics and MRI based radiomics nomograms can predict iPFS and short-term efficacy of third-generation EGFR-TKI in EGFR-mutated lung adenocarcinoma with brain metastases

  • 0Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences, 440 Jiyan Road, Jinan, Shandong, 250117, China.
Bmc Cancer +

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March 22, 2024

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March 22, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Predicting treatment response in EGFR-mutated lung adenocarcinoma with brain metastases is crucial. Combined clinical and MRI radiomics nomograms effectively predict short-term efficacy and intracranial progression-free survival (iPFS) with third-generation EGFR-TKI therapy.

Area Of Science

  • Oncology
  • Radiology
  • Genetics

Background

  • Brain metastases in EGFR-mutated lung adenocarcinoma pose significant treatment challenges.
  • Predicting short-term efficacy and intracranial progression-free survival (iPFS) is vital for personalized therapy.
  • Third-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are a key treatment modality.

Purpose Of The Study

  • To construct and validate nomograms for predicting short-term efficacy of third-generation EGFR-TKI therapy.
  • To develop predictive models for intracranial progression-free survival (iPFS) in EGFR-mutated lung adenocarcinoma with brain metastases.
  • To integrate clinical characteristics and MRI radiomics for enhanced predictive accuracy.

Main Methods

  • 194 patients with EGFR-mutated lung adenocarcinoma and brain metastases receiving third-generation EGFR-TKI were analyzed.
  • Radiomics features from brain MRI were extracted and screened using LASSO regression.
  • Clinical risk factors were identified via logistic and Cox regression; combined (C+R) nomograms were built and validated.

Main Results

  • The study reported an overall response rate (ORR) of 71.1% and a disease control rate (DCR) of 91.8%.
  • Median iPFS was 12.67 months, with significant differences observed between high- and low-risk groups.
  • Combined C+R nomograms demonstrated high predictive accuracy, with C-indexes up to 0.901 in the training cohort.

Conclusions

  • Third-generation EGFR-TKI therapy shows significant efficacy in EGFR-mutated lung adenocarcinoma patients with brain metastases.
  • Combined clinical and radiomics nomograms (C+R) provide a reliable tool for predicting treatment efficacy and iPFS.
  • These nomograms can aid in optimizing individualized treatment strategies for this patient population.

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