Background: Carcinomatous meningitis (CM) in non-small cell lung cancer (NSCLC) has no standard treatment and poor prognosis, with a median survival of 4-9 weeks. Recently, NSCLC subgroups with driver mutations were identified, with mutation of epidermal growth factor receptor gene (
EGFR) being the most frequent. This retrospective study investigated the frequency and characteristics of CM in
EGFR-mutated patients.
Methods: From April 2007 to June 2013, consecutive NSCLC patients were screened for
EGFR mutations using the PNA-LNA PCR Clamp in one institution. Diagnosis of CM was based on the presence of malignant cells in cerebrospinal fluid and/or MRI detection of leptomeningeal enhancement. Incidence and clinical features of CM patients were investigated from medical records.
Results: Of 1343 NSCLC patients, 387 (28.8%) harboring
EGFR mutations. Thirty-five patients (2.6%) developed CM; the rate of CM in
EGFR-mutated patients (25/387, 6.46%) was significantly higher than in patients lacking the mutations (10/956, 1.04%;
p < 0.01). Multiplex logistic analysis indicated strong associations between CM and
EGFR mutation (
p < 0.0001), brain metastasis (
p < 0.0001) and non-squamous cell carcinoma histology (
p = 0.026).
Conclusions: NSCLC patients with
EGFR mutations are more likely to develop CM than those with wild
EGFR.
View full abstract