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Central nervous systemic efficacy of immune checkpoint inhibitors and concordance between intra/extracranial response in non-small cell lung cancer patients with brain metastasis.

Authors :
Kang S
Jeong H
Park JE
Kim HS
Kim YH
Lee DH
Kim SW
Lee JC
Choi CM
Yoon S
Source :
Journal of cancer research and clinical oncology [J Cancer Res Clin Oncol] 2023 Jul; Vol. 149 (8), pp. 4523-4532. Date of Electronic Publication: 2022 Sep 22.
Publication Year :
2023

Abstract

Purpose: Immune checkpoint inhibitors (ICIs) markedly improve the clinical outcomes of advanced non-small-cell lung cancer (NSCLC). However, the intracranial efficacy of ICI is not well elucidated, and previous studies showed discordant outcomes of ICI between intracranial and extracranial diseases. We aimed to evaluate the clinical outcomes and the intracranial and extracranial response of patients with NSCLC and brain metastasis who were treated with ICI in the real-world setting.<br />Methods: A total of 55 patients (median age, 63 years [range 42-80]; male, 78%) who had NSCLC with brain metastasis and treated with ICI monotherapy were retrospectively analyzed. We separately assessed the response rates of brain lesions and systemic lesions, and estimated the overall survival (OS) and progression-free survival (PFS).<br />Results: The median OS and overall PFS were 17.0 months (95% CI 10.3-25.6) and 3.19 months (95% CI 2.24-5.03), respectively. The intracranial objective response rate and disease control rate of ICI were 36 and 54%, respectively. Among the 44 patients who showed disease progression, only 32% (nā€‰=ā€‰14) showed concordant outcomes and 9 patients (20%) showed opposing discordant outcomes. Eight patients continued ICI with local brain therapy after intracranial progression, and their median extracranial PFS and OS were 15 months (95% CI 5.0-not assessed [NA]) and 23.8 months (95% CI 14.7-NA), respectively.<br />Conclusions: ICI monotherapy had a clinically meaningful intracranial efficacy in NSCLC patients with brain metastasis. Watchful waiting and close monitoring without local radiotherapy might be feasible in NSCLC patients with asymptomatic active brain metastasis.<br /> (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Details

Language :
English
ISSN :
1432-1335
Volume :
149
Issue :
8
Database :
MEDLINE
Journal :
Journal of cancer research and clinical oncology
Publication Type :
Academic Journal
Accession number :
36136277
Full Text :
https://doi.org/10.1007/s00432-022-04251-3