Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutations

Abstract Background A retrospective analysis verified the role of gene mutations in brain metastasis in patients with non‐small cell lung cancer (NSCLC). Methods Data from 552 patients with advanced NSCLC treated from January 2015 to June 2017 in the Affiliated Cancer Hospital of Zhengzhou Universit...

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Main Authors: Huijuan Wang, Ziqi Wang, Guowei Zhang, Mina Zhang, Xiaojuan Zhang, Haixia Li, Xuanxuan Zheng, Zhiyong Ma
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.2706
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author Huijuan Wang
Ziqi Wang
Guowei Zhang
Mina Zhang
Xiaojuan Zhang
Haixia Li
Xuanxuan Zheng
Zhiyong Ma
author_facet Huijuan Wang
Ziqi Wang
Guowei Zhang
Mina Zhang
Xiaojuan Zhang
Haixia Li
Xuanxuan Zheng
Zhiyong Ma
author_sort Huijuan Wang
collection DOAJ
description Abstract Background A retrospective analysis verified the role of gene mutations in brain metastasis in patients with non‐small cell lung cancer (NSCLC). Methods Data from 552 patients with advanced NSCLC treated from January 2015 to June 2017 in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. Next‐generation sequencing was used to detect mutations in eight reported driver genes and various risk factors were evaluated. Results Of the 552 patients with advanced NSCLC, 153 (27.7%) had brain metastases. The univariate analysis showed that age (P = .008), gender (P = .016), smoking history (P = .010), lymph node metastasis (P = .003), and three driver genes, positive epidermal growth factor receptor (EGFR) mutation (P = .001), positive anaplastic lymphoma kinase (ALK) gene fusion (P = .021), and positive rearranged during transfection (RET) gene fusion (P = .003), were the factors influencing the incidence of brain metastasis. Logistic multivariate regression analysis revealed that positive EGFR mutation (P = .012), positive ALK gene fusion (P = .015), positive RET gene fusion (P = .003), pathological type (P = .009), lymph node N2‐3 metastasis (P < .001), and a younger age (P < .001) were independent risk factors for brain metastasis. In addition, a receiver operating characteristic (ROC) curve was plotted with the above factors with an area under the curve = 0.705 (P < .001). Conclusions An EGFR mutation, ALK gene fusion, and RET gene fusion in advanced NSCLC patients play roles in brain metastasis as positive driver genes. Impact An EGFR mutation, and ALK and RET gene fusions are risk factors for brain metastasis in advanced NSCLC patients.
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spelling doaj-art-e5c7a6a64a964a449420266a284e120b2025-08-25T10:14:04ZengWileyCancer Medicine2045-76342020-01-019248749510.1002/cam4.2706Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutationsHuijuan Wang0Ziqi Wang1Guowei Zhang2Mina Zhang3Xiaojuan Zhang4Haixia Li5Xuanxuan Zheng6Zhiyong Ma7Department of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaDepartment of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaDepartment of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaDepartment of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaDepartment of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaDepartment of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaDepartment of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaDepartment of Medical Oncology The Affiliated Cancer Hospital of Zhengzhou University Henan Cancer Hospital Zhengzhou ChinaAbstract Background A retrospective analysis verified the role of gene mutations in brain metastasis in patients with non‐small cell lung cancer (NSCLC). Methods Data from 552 patients with advanced NSCLC treated from January 2015 to June 2017 in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively analyzed. Next‐generation sequencing was used to detect mutations in eight reported driver genes and various risk factors were evaluated. Results Of the 552 patients with advanced NSCLC, 153 (27.7%) had brain metastases. The univariate analysis showed that age (P = .008), gender (P = .016), smoking history (P = .010), lymph node metastasis (P = .003), and three driver genes, positive epidermal growth factor receptor (EGFR) mutation (P = .001), positive anaplastic lymphoma kinase (ALK) gene fusion (P = .021), and positive rearranged during transfection (RET) gene fusion (P = .003), were the factors influencing the incidence of brain metastasis. Logistic multivariate regression analysis revealed that positive EGFR mutation (P = .012), positive ALK gene fusion (P = .015), positive RET gene fusion (P = .003), pathological type (P = .009), lymph node N2‐3 metastasis (P < .001), and a younger age (P < .001) were independent risk factors for brain metastasis. In addition, a receiver operating characteristic (ROC) curve was plotted with the above factors with an area under the curve = 0.705 (P < .001). Conclusions An EGFR mutation, ALK gene fusion, and RET gene fusion in advanced NSCLC patients play roles in brain metastasis as positive driver genes. Impact An EGFR mutation, and ALK and RET gene fusions are risk factors for brain metastasis in advanced NSCLC patients.https://doi.org/10.1002/cam4.2706brain metastasesclinicopathological featuresdriver geneslung cancernon‐small cell lung cancer (NSCLC)targeted therapy
spellingShingle Huijuan Wang
Ziqi Wang
Guowei Zhang
Mina Zhang
Xiaojuan Zhang
Haixia Li
Xuanxuan Zheng
Zhiyong Ma
Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutations
Cancer Medicine
brain metastases
clinicopathological features
driver genes
lung cancer
non‐small cell lung cancer (NSCLC)
targeted therapy
title Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutations
title_full Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutations
title_fullStr Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutations
title_full_unstemmed Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutations
title_short Driver genes as predictive indicators of brain metastasis in patients with advanced NSCLC: EGFR, ALK, and RET gene mutations
title_sort driver genes as predictive indicators of brain metastasis in patients with advanced nsclc egfr alk and ret gene mutations
topic brain metastases
clinicopathological features
driver genes
lung cancer
non‐small cell lung cancer (NSCLC)
targeted therapy
url https://doi.org/10.1002/cam4.2706
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