{"doi":"10.1016/j.jtocrr.2023.100607","title":"Intracranial Outcomes of De Novo Brain Metastases Treated With Osimertinib Alone in Patients With Newly Diagnosed EGFR-Mutant NSCLC","abstract":"Introduction: Patients with EGFR-mutant NSCLC have a high incidence of brain metastases. The EGFR-directed tyrosine kinase inhibitor osimertinib has intracranial activity, making the role of local central nervous system (CNS)-directed therapies, such as radiation and surgery, less clear. Methods: Patients with EGFR-mutant NSCLC and brain metastases who received osimertinib as initial therapy after brain metastasis diagnosis were included. Individual lesion responses were assessed using adapted RANO-BM criteria. CNS progression and local progression of brain metastasis from osimertinib start were analyzed using cumulative incidence treating death as a competing risk. Overall survival was estimated using Kaplan-Meier methodology. Results: There were 36 patients who had a median interval from brain metastasis diagnosis to first-line osimertinib initiation of 25 days. In total, 136 previously untreated brain metastases were tracked from baseline. Overall, 105 lesions (77.2%) had complete response and 31 had partial response reflecting best objective response of 100%. Best response occurred at a median of 96 days (range: 28-1113 d) from baseline magnetic resonance imaging. This reflects a best objective response rate of 100%. Two-year overall survival was 80%. CNS progression rates at 1-, 2-, and 3-years post-osimertinib were 21%, 32%, and 41%, respectively. Lesion-level local failure was estimated to be 0.7% and 4.7% at 1- and 2-years post-osimertinib, respectively. No clinicodemographic factors including brain metastasis number were associated with post-osimertinib progression. Conclusions: Intracranial response to osimertinib is excellent for patients with EGFR-mutant NSCLC with de novo, previously untreated brain metastases. Very low local failure rates support a strategy of upfront osimertinib alone in selected patients.","journal":"JTO Clinical and Research Reports","year":2023,"id":352001,"datarank":0.3453877639491069,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.0,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9494,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1097095,"name":"Ryka Sehgal","orcid":"0000-0002-2500-2550","position":1,"is_corresponding":false},{"id":641500,"name":"Rachel Saganty","orcid":null,"position":2,"is_corresponding":false},{"id":288021,"name":"Anne S. Reiner","orcid":"0000-0002-1258-6112","position":3,"is_corresponding":false},{"id":1097096,"name":"Ahmet Turan Ilıca","orcid":"0000-0002-8701-6042","position":4,"is_corresponding":false},{"id":976779,"name":"Emily Miao","orcid":"0000-0001-8848-2830","position":5,"is_corresponding":false},{"id":227116,"name":"Bob T. Li","orcid":"0000-0001-6661-8733","position":6,"is_corresponding":false},{"id":39879,"name":"Gregory J. Riely","orcid":"0000-0001-5357-4313","position":7,"is_corresponding":false},{"id":235761,"name":"Helena A. Yu","orcid":"0000-0002-0377-9510","position":8,"is_corresponding":false},{"id":316498,"name":"Katherine S. Panageas","orcid":"0000-0002-6591-604X","position":9,"is_corresponding":false},{"id":281410,"name":"Robert J. Young","orcid":"0000-0001-7003-3017","position":10,"is_corresponding":false},{"id":764251,"name":"Luke Pike","orcid":"0000-0001-9622-7442","position":11,"is_corresponding":false},{"id":374896,"name":"Nelson S. Moss","orcid":"0000-0002-0930-1681","position":12,"is_corresponding":false},{"id":363895,"name":"Brandon S. Imber","orcid":"0000-0002-1281-5915","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:12:45.897709Z","pmid":"38124791","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}