Converging survival trends in non-small cell lung cancer patients with and without brain metastasis receiving state-of-the-art treatment

Itamar Averbuch*, Roi Tschernichovsky, Shlomit Yust-Katz, Ofer Rotem, Dror Limon, Noga Kurman, Oded Icht, Daniel Reinhorn, Mor Moskovitz, Ekaterina Hanovich, Alexandra Benouaich-Amiel, Tali Siegal, Alona Zer, Omer Gal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Introduction: Historically, patients with brain metastasis (BM) have been excluded from clinical trials investigating treatments for non-small cell lung cancer (NSCLC) due to their unfavorable prognosis. Advanced treatments have increased survival prospects for NSCLC patients with BM. This study evaluated the life expectancy of NSCLC patients with and without BM in the context of contemporary treatments. Methods: Outcome data were collected for patients with advanced NSCLC attending a tertiary medical center between 2015 and 2020. Patients were stratified according to BM status and compared for overall survival (OS) using log-rank and Cox regression analyses. Results: The cohort included 360 patients with NSCLC of whom 134 (37.2%) had BM. Most (95%) of cases of BM developed within the first two years: 63% at diagnosis, 18% during the first year, 14% during the second year. There was no significant difference in OS between patients without BM and those with BM (median 23.7 vs. 22.3 months, HR = 0.97, p = 0.82); patients with BM and a targetable or non-targetable mutation (40.2 vs. 31.4 months, HR = 0.93, p = 0.84, and 20.7 vs. 19.87 months, HR = 0.95, p = 0.75, respectively); and patients with symptomatic BM (23.7 vs. 19.8 months, HR = 0.95, p = 0.78). Treatment for BM (95% of patients) consisted of stereotactic radiosurgery or tyrosine kinase inhibitors, with corresponding intracranial control rates of 90% and 86%. Conclusion: The results imply that the presence of BM has no impact on the prognosis of NSCLC. The practice of excluding NSCLC patients with BM from clinical trials warrants reconsideration.

Original languageEnglish
Pages (from-to)461-469
Number of pages9
JournalJournal of Neuro-Oncology
Issue number3
StatePublished - Feb 2024


FundersFunder number
Porter School of Environmental Studies, Tel Aviv University
Tel Aviv University
Claire and Amédée Maratier Institute for the Study of Blindness and Visual Disorders, Tel Aviv University
Center for Nanoscience and Nanotechnology, Tel Aviv University
Adams Super Center for Brain Studies,Tel Aviv University
Cancer Biology Research Center, Tel Aviv University
Varda and Boaz Dotan Research Center for Hemato-Oncology Research, Tel Aviv University
Manna Center for Plant Biosciences, Tel Aviv University
Sagol School of Neuroscience, Tel Aviv University
Check Point Institute for Information Security, Tel Aviv University
Yitzhak and Chaya Weinstein Research Institute for Signal Processing, Tel Aviv University


    • Brain metastasis
    • Non small cell lung cancer
    • Prognosis


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