1160 / 1578
/
Magnuson JCO 2016
Brain mets in patients with driver mutations
Retrospective multi-institution study: n=351
Ø
Upfront SRS in small & asymptomatic brain mets
improves OS
Brain
mets
EGFR-
TKI
N=131
WBI
N=120
SRS
N=100
n < 5
64% 27% 72%
< 1cm
66% 35% 44%
asympto
matic
88% 49% 51%
07.09.17
ESTRO SBRT COURSE 2017 - Matthias Guckenberger
17
/
Ø
Excellent PFS in patients treated with Alectinib
Ø
Role or radiotherapy in drugs with goof BBB penetration?
Brain mets in patients with driver mutations
Randomized Japanese study of Crizotibib vs Alectinib in FL
14 – 28% with brain metastases
Nokihara ASCO 2016
PFS (%)
Time (months)
0 1
3
6
0
20
40
60
80
100
9
12
15
18
21
24
27
No. of patientsat risk
Alectinib
Crizotinib
103
104
103
102
93
86
76
65
49
40
36
21
27
14
9
4
1
NR
10.2 months
Primary EP PFS
Overall With BM
HR 0.24 HR 0.08
07.09.17
ESTRO SBRT COURSE 2017 - Matthias Guckenberger
18