First treatment choice for XXXX (pts) with advanced @entity1149 ( @entity1149 ) presenting with brain @entity3 (BM): A preliminary report of a multi-institutional survey.

@entity1 @entity1149 @entity3666 @entity1685 @entity136 @entity3 @entity902
UNASSIGNED: 7365 Background: Phase III trials evaluating @entity902 -based chemotherapy (CT) have recently challenged the standard option of radiotherapy (WBRT) in the treatment of @entity1149 pts presenting with brain metastases. Although the current options are often driven by the clinical status (e.g. BM symptoms) and the local practice (e.g. referred specialist and hospital resources), the common approach including WBRT followed by CT could not represent the treatment of choice when BM symptoms are absent or controlled by supportive therapy. To analyze the decision-tree by which the participating Institutions guided the treatment choices and to evaluate the activity of CT as frontline treatment in an unselected @entity1 population presenting with BM at diagnosis, we conducted the present survey. METHODS: This preliminary analysis includes a subset of 49 pts fulfilling the following criteria: pathologic proof of @entity1149 , stage IV with BM at first diagnosis, age <=  80 yrs, ECOG PS <=  2, eligibility for @entity902 -based regimens. @entity1 characteristics included median age 63 yrs (range 35-77), median @entity3666 , histology: 32 adeno, 11 squamous, 6 undifferentiated. BMs were the unique site of @entity3 in 22% of pts, multiple sites were found in 57% of cases. The first treatment choice included CT in 27 pts and local treatment (WBRT or surgery) followed by CT in 22. @entity902 -based CT included @entity136 in 39 pts. RESULTS: The choice of treatment was mainly guided by BM symptoms with CT selected in 38% vs 74% of pts, whether or not symptoms were present. Regardless of treatment, the overall BM response was 41% (33% vs 50% for CT and local treatment subgroups, respectively). For the general population the overall response, PFS and @entity1685 were 36%, 7 and 11 months, respectively. CONCLUSIONS: This preliminary analysis emphasizes the worth of clinical presentation in the decision making process. The activity of CT alone in BM control is confirmed also in the current practice. The optimal treatment choice for pts presenting with BM should deserve prospective evaluation. A subset analysis will be presented. (Supported by FORO) No significant financial relationships to disclose.
