{"id":24190,"date":"2026-05-26T15:47:02","date_gmt":"2026-05-26T19:47:02","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=24190"},"modified":"2026-06-16T15:51:32","modified_gmt":"2026-06-16T19:51:32","slug":"duration-of-systemic-therapy-in-patients-with-metastatic-egfr-mutated-non-small-cell-lung-cancer-and-brain-metastases","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/duration-of-systemic-therapy-in-patients-with-metastatic-egfr-mutated-non-small-cell-lung-cancer-and-brain-metastases\/","title":{"rendered":"Duration of systemic therapy in patients with metastatic EGFR-mutated non-small cell lung cancer and brain metastases"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Osimertinib, a third-generation epidermal growth factor receptor (EGFR) inhibitor, has demonstrated strong central nervous system (CNS) activity in EGFR-mutated metastatic non-small cell lung cancer (mNSCLC). We hypothesized that osimertinib would be associated with longer first-line treatment duration than the first-generation EGFR inhibitor gefitinib among patients with brain metastases.<\/p>\n<p><strong>Methods<\/strong> \u2014 We performed an observational study using provincial administrative databases. All patients with EGFR-positive mNSCLC treated between 2007 and 2024 who received first-line osimertinib or gefitinib and underwent brain radiotherapy within four weeks of systemic therapy initiation, serving as a surrogate for brain metastasis diagnosis, were included for analysis. The primary outcome was duration of first-line systemic therapy. Secondary outcomes included overall survival (OS) and CNS radiation progression-free survival (CNS-rPFS), estimated using Kaplan-Meier methods. Propensity score matching was used to adjust for baseline differences.<\/p>\n<p><strong>Results<\/strong> \u2014 Among 3,541 eligible patients, 481 met inclusion criteria (osimertinib: 222; gefitinib: 259). Median first-line treatment duration was significantly longer with osimertinib than with gefitinib (12.6 vs. 6.4 months; P&lt;0.001). Osimertinib was also associated with longer median CNS-rPFS (21.7 vs. 13.5 months; P&lt;0.001) and OS (24.7 vs. 13.6 months; P&lt;0.001). After propensity score matching (n=412), these differences persisted for treatment duration (12.9 vs. 6.8 months), CNS-rPFS (24.9 vs. 14.5 months), and OS (25.6 vs. 14.6 months), all P&lt;0.001.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 In real-world practice, osimertinib is associated with longer first-line treatment duration, improved CNS control, and longer survival compared with gefitinib among EGFR-positive mNSCLC patients with brain metastases.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Osimertinib, a third-generation epidermal growth factor receptor (EGFR) inhibitor, has demonstrated strong central nervous system (CNS) activity in EGFR-mutated metastatic non-small cell lung cancer (mNSCLC). We hypothesized that osimertinib would be associated with longer first-line treatment duration than the first-generation EGFR inhibitor gefitinib among patients with brain metastases. Methods \u2014 We performed an [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[38,56],"migration-helper-qa-sample-set":[],"class_list":["post-24190","journal_article","type-journal_article","status-publish","hentry","topic-cancer-and-cancer-screening","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Yan M, Tjong M, Coburn N, Nguyen L, Sahgal A, Louie AV, Parmar A. <em>Transl Lung Cancer Res<\/em>. 2026; 15(5):120. Epub 2026 May 26.","source_url":"https:\/\/doi.org\/10.21037\/tlcr-2026-1-0107","ices_scientist":[1202],"site":[6733],"research_program":[6741],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Duration of systemic therapy in patients with metastatic EGFR-mutated non-small cell lung cancer and brain metastases<\/title>\n<meta name=\"description\" content=\"Background \u2014 Osimertinib, a third-generation epidermal growth factor receptor (EGFR) inhibitor, has demonstrated strong central nervous system (CNS)\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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