The following is a summary of “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,” published in the March 2024 issue of Oncology by Qi et al.
Understanding short-term efficacy and intracranial progression-free survival (iPFS) in patients with EGFR-mutated lung adenocarcinoma and brain metastases undergoing third-generation EGFR tyrosine kinase inhibitor (EGFR-TKI) therapy is crucial for personalized treatment strategies. Here, researchers aimed to develop and validate nomograms integrating clinical characteristics and magnetic resonance imaging (MRI) radiomics to predict short-term efficacy and iPFS in this patient population.
A cohort of 194 EGFR-mutated lung adenocarcinoma patients with brain metastases receiving third-generation EGFR-TKI therapy between January 1, 2017, and March 1, 2023, was included. Patients were randomly divided into training and validation cohorts. Radiomics features from brain MRI were selected using least absolute shrinkage and selection operator (LASSO) regression, while logistic regression and Cox proportional hazards regression identified clinical risk factors. Nomograms were constructed for short-term efficacy and iPFS prediction, incorporating single clinical (C), single radiomics (R), and combined (C+R) factors. Model performance was assessed using calibration curves, C-index, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA).
The overall response rate (ORR) was 71.1%, with a disease control rate (DCR) of 91.8% and a median iPFS of 12.67 months (interquartile range [IQR]: 7.88–20.26 months). Patients with high iPFS rad-scores and high-risk profiles showed significantly longer iPFS. In the short-term efficacy model, the C-indexes for the C + R nomograms were 0.867 (95%CI: 0.835-0.900) in the training cohort and 0.803 (95%CI: 0.753–0.854) in the validation cohort. For the iPFS model, the C-indexes were 0.901 (95%CI: 0.874–0.929) in the training cohort and 0.753 (95%CI: 0.713–0.793) in the validation cohort.
Third-generation EGFR-TKI therapy exhibited significant efficacy in EGFR-mutated lung adenocarcinoma with brain metastases. The combined C+R nomograms provide valuable tools for predicting short-term efficacy and iPFS in this patient population, facilitating informed treatment decisions and personalized care pathways.
Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12121-z