Patients with Non-Small-Cell Lung Cancer with Brain Metastases: New Data on the Significant Challenges for which Physicians Feel Unequipped

27 October 2021

Non-small-cell lung cancer (NSCLC) accounts for 85 per cent of lung cancers, with 40 per cent of patients presenting at an advanced stage, including patients with metastatic disease.

40 per cent of healthcare providers (HCPs) (oncologists and respiratory specialists) surveyed across the five countries in Europe and the United States feel less than well equipped (meaning to be somewhat, fairly poorly or very poorly equipped) to care for non-small-cell lung cancer (NSCLC) patients with brain metastases, according to a new survey carried out by Ipsos MORI in collaboration with the European Cancer Organisation (E.C.O.). The report is to be presented at the E.C.O. Community 365 Roundtable Meeting on Metastatic Cancer on 27 October.

“The findings suggest what the lung cancer community has unfortunately been aware of for too long,” said Dr Matti Aapro, President of the European Cancer Organisation. “As treatment options expand for the NSCLC patient community, it is critical that we promptly address the complex challenges of coordinating care for patients that also present with brain metastases. The same is also true for other cancers, where valuable options are either ignored or not available.”

Despite recent progresses, many people with NSCLC face a poor prognosis with five-year survival declining considerably at more advanced stages of the disease. NSCLC patients with brain metastases have unique care needs that are significantly more complex for patients, caregivers, and healthcare providers.

“Treatment of patients with brain metastases is considerably more complex than treating patients without brain metastases, and their support needs are substantial,” said Kathy Oliver, Co-Chair of the E.C.O. Patient Advisory Committee and Chair and Founding Co-Director of the International Brain Tumour Alliance (IBTA).

“It is imperative that we work across the advocacy, clinical, and policy communities to ensure that healthcare providers and people living with brain metastases can access high-quality treatments and multidisciplinary care. We need to sharpen the focus on how we can collectively and better address the vast unmet needs of the challenging and dual diagnosis of advanced NSCLC and brain metastases,” added Dr Anne-Marie Baird, Member of the E.C.O. Patient Advisory Committee and President of Lung Cancer Europe.

The findings of the survey, which was fielded by Ipsos MORI in September 2021 and surveyed 350 oncologists and respiratory specialists from the United States, European Union (four countries in EU: Germany, France, Italy, Spain), and the United Kingdom, underlined the complexity of NSCLC and the issues that healthcare providers and their patients face:

  • 40% of HCPs surveyed felt less than well equipped (somewhat/fairly and very poorly equipped) to managing NSCLC patients with brain metastases, and 39% say having timely access to biomarker tests is challenging.
  • Three in four HCPs surveyed agreed that coordination of medical care is more of a challenge for NSCLC patients with brain metastases vs. NSCLC patients without brain metastases.
  • Two in five physicians (41%) find it challenging being open and honest with the patient if asked difficult questions (e.g. on prognosis, likelihood of recurrence, etc).
  • Half of the HCPs (51%) report providing emotional and/or moral support to the patient and their caregivers and family as a challenge.
  • Beyond treatment, having a survivorship plan is seen as important for patients, according to 30% of HCPS surveyed but comes behind a focus on psychological support (e.g. access to psychotherapists/psychologists/ counselling) for patients (55%), practical support for caregivers (46%) and emotional support for caregivers (43%).
  • 52% of the HCPs surveyed noted a lack of time to discuss their condition with patients/caregivers, and 44% acknowledged a lack of quality information also compounds the challenge of treating these patients.

Some HCPs surveyed (24%) also reported dissatisfaction with the amount of information available for patients and caregivers, which is a crucial area for improvement to address unmet patient needs. According to the HCPS in the survey, patients and their caregivers would like to know more about their condition in terms of:

  • Life expectancy (64%)
  • Side effect management (52%)
  • Radiation therapies (52%)
  • Palliative and end of life care (52%)
  • Benefits and risks of treatment for informed decision making (47%)
  • Systemic medical treatments available (46%)

For more information on the survey, click here.



1. About the Survey

The policy needs of metastatic cancer have been comparatively neglected at the European and national levels. The European Cancer Organisation is pleased to be working with many organisations within its membership and networks to address and make more prominent the challenges and opportunities for improved care for patients with metastatic cancer. In preparation for the Community 365 Roundtable Meeting on Metastatic Cancer, Ipsos MORI conducted an online survey among 350 participants who chose to take part in the survey (Oncologists or Respiratory Specialists directly involved in treating a minimum of five NSCLC patients in the past 6 months of which at least one has brain metastasis and practicing for 3-30 years) across US (100), UK (50), Germany (50), France (50), Spain (50), Italy (50) between 3rd and 27th September 2021.

As well as providing the results individually for each of the six countries, Ipsos has produced an overall total based on country averages. This is where the results from each country have the same weight rather than the true population proportions across the six countries. Survey results can be found here.

This survey was funded by Regeneron and Sanofi to discover the unmet needs of NSCLC patients living with brain metastases.

2. About the Community 365 Roundtable Meeting on Metastatic Cancer

Taking place on Wednesday 27 October from 10:00-12:30 CEST, this meeting will bring together leading policy-makers, politicians, oncology experts and patient advocates to discuss the implementation of Europe’s Beating Cancer Plan and Cancer Mission, as well as other EU policy developments relating to metastatic cancer.

The Roundtable will provide the opportunity to present the results of a survey of healthcare professionals in Europe and the United States, focused on unmet needs of Non-Small Cell Lung Cancer (NSCLC) patients with brain metastases. In addition, it will investigate key policy needs to improve the quality of care provided to patients with metastatic cancer and will also review technological and practice developments with references to the examples of breast, prostate and lung cancer. More information is available here.

3. About Non-Small-Cell Lung Cancer (NSCLC)
NSCLC is the most common type of lung cancer, accounting for 85% of all lung cancer diagnoses.1
Lung cancer has the lowest 5-year survival rate of the other most common cancers: only 18%, versus prostate at 99%; breast at 89%; and colorectal at 65%.2
Brain metastases are experienced by a proportion of NSCLC patients. In a 2018 study, brain metastases were observed in 10.4% of the over 450,000 patients with NSCLC overall.3



1. Ali, A., Griffin, J., Arnold, A. and Ellis, P, 2021. Survival of Patients with Non-Small Cell Lung Cancer after Diagnoses of Brain Metastases

2. Lung Cancer Europe.

3. Waqar et al, 2018, Non-small-cell Lung Cancer With Brain Metastasis at Presentation