The role of EGFR mutation as a prognostic factor in survival after diagnosis of brain metastasis in non-small cell lung cancer: a systematic review and meta-analysis.
BACKGROUND
The brain is a common site for metastasis in non-small-cell lung cancer (NSCLC). This study was designed to evaluate the relationship between the mutational of the epidermal growth factor receptor (EGFR) and overall survival (OS) in NSCLC patients with brain metastases.


METHODS
Searches were performed in PubMed, EmBase, and the Cochrane Library to identify studies evaluating the association of EGFR mutation with OS in NSCLC patients through September 2017.


RESULTS
4373 NSCLC patients with brain metastases in 18 studies were involved. Mutated EGFR associated with significantly improved OS compared with wild type. Subgroup analyses suggested that this relationship persisted in studies conducted in Eastern, with retrospective design, with sample size ≥500, mean age of patients ≥65.0 years, percentage male < 50.0%, percentage of patients receiving tyrosine kinase inhibitor ≥30.0%. Finally, although significant publication bias was observed using the Egger test, the results were not changed after adjustment using the trim and fill method.


CONCLUSIONS
This meta-analysis suggests that EGFR mutation is an important predictive factor linked to improved OS for NSCLC patients with brain metastases. It can serve as a useful index in the prognostic assessment of NSCLC patients with brain metastases.
['Li|Wen-Ya|WY|', 'Zhao|Ting-Ting|TT|', 'Xu|Hui-Mian|HM|', 'Wang|Zhen-Ning|ZN|', 'Xu|Ying-Ying|YY|', 'Han|Yunan|Y|', 'Song|Yong-Xi|YX|', 'Wu|Jian-Hua|JH|', 'Xu|Hao|H|', 'Yin|Song-Cheng|SC|', 'Liu|Xing-Yu|XY|', 'Miao|Zhi-Feng|ZF|']
D014408:Biomarkers, Tumor D001932:Brain Neoplasms D002289:Carcinoma, Non-Small-Cell Lung D066246:ErbB Receptors D006801:Humans D008175:Lung Neoplasms D009154:Mutation D011379:Prognosis
EGFR Brain metastasis Lung cancer Meta analysis Prognosis