Multicenter retrospective study of pattern of brain metastases and survival in lung adenocarcinoma with KRAS or EGFR mutation

The multicenter real-world KOMPASS study in Germany investigated the pattern of brain metastases (BrM) and survival in lung adenocarcinoma with KRAS or EGFR mutations. The study included 326 NSCLC patient with stage IV adenocarcinoma and either KRAS mutation (n=90), EGFR mutation (n=87), or no known driver mutation (n=149). The prevalence of BrM was higher in patients with KRAS mutation (40%) or EGFR mutation (39%) than in patients without driver mutation (27%). Patients with KRAS mutation or no driver mutation significantly more often had single BrM, whereas patients with EGFR mutation had multiple BrM (median number 1, 2, and 4, respectively). The presence of BrM did not adversely affect overall survival in patient with KRAS-mutation (22.3 versus 19.2 months) and patients with no driver mutation (8.9 versus 10.9 months), whereas in patients with EGFR mutation BrM was associated with inferior OS (20.5 versus 13.2 months; p=0.0004).