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@ARTICLE{Faehling:305554,
      author       = {M. Faehling and S. Fallscheer and J. Schmiederer and J.
                      Sträter and P. Christopoulos and C. Lengerke$^*$ and H.
                      Seifarth},
      title        = {{P}attern of brain metastases and survival in lung
                      adenocarcinoma with {KRAS} or {EFGR} mutation.},
      journal      = {Lung cancer},
      volume       = {209},
      issn         = {0169-5002},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2025-02224},
      pages        = {108803},
      year         = {2025},
      abstract     = {NSCLC with mutations of the KRAS or EGFR gene is associated
                      with a high risk of brain metastases (BRA). There are few
                      data on the prevalence and pattern of BRA and on survival in
                      unselected KRAS or EGFR patients.This real-world analysis
                      (KOMPASS-study) included 326 NSCLC patients with stage IV
                      adenocarcinoma and either KRAS mutation (n = 90), EGFR
                      mutation (n = 87), or no known driver mutation (n = 149).
                      Prevalence, number, and size of BRA, and the effect of BRA
                      on overall survival (OS) were analyzed.The prevalence of BRA
                      was higher in KRAS patients (40 $\%)$ or EGFR patients (39
                      $\%)$ than in no-driver patients (27 $\%).$ KRAS patients
                      and no-driver patients significantly more often had single
                      BRA, whereas EGFR patients had multiple BRA (median number
                      1, 2, and 4, respectively). The presence of BRA did not
                      adversely affect OS in KRAS patients (22.3 vs. 19.2 months,
                      HR 0.91) and no-driver patients (8.9 vs. 10.9 months, HR
                      0.99). EGFR patients with BRA had inferior OS (20.5 vs. 35.5
                      months, HR 2.70, p = 0.0004). Patients with single BRA had
                      improved OS (22.3 vs. 13.2 months, p = 0.013).The lack of a
                      negative effect of BRA on OS in KRAS patients or no-driver
                      patients may be due to the frequent finding of a single BRA
                      amenable to ablative treatment. The negative effect of BRA
                      on OS in EGFR patients points to a distinct biology of
                      EGFR-mutated NSCLC leading to a characteristic radiological
                      pattern of multiple BRA which are not amenable to ablative
                      treatment.},
      keywords     = {CNS metastases (Other) / EGFR (Other) / Exon 21 (Other) /
                      G12C (Other) / KRAS (Other) / Lung cancer (Other) / Number
                      of brain metastases (Other) / Overall survival (Other) /
                      Real world data (Other) / Size (Other)},
      cin          = {TU01},
      ddc          = {610},
      cid          = {I:(DE-He78)TU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41151358},
      doi          = {10.1016/j.lungcan.2025.108803},
      url          = {https://inrepo02.dkfz.de/record/305554},
}