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 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