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Background: Immune checkpoint inhibitors (ICIs) are an emerging tool in the treatment of brain metastases (BMs), Stereotactic radiosurgery (SRS), traditionally used for BMs, elicits an immune brain response and can act synergistically with ICIs. We aim to investigate the efficacy of ICI administered with SRS and determine the impact of timing on BM response. Methods: A systematical search was performed to identify potential studies concerning BMs managed with SRS alone or with SRS + ICI with relative timing administration (ICI concurrent with SRS, ICI noncon-current with SRS, SRS before ICI, SRS after ICI). The overall survival (OS), 12-month OS, local progression-free survival (LPFS), 12-month local brain control (LBC), distant progression-free survival (DPFS), 12-month distant brain control (DBC), and adverse events (intracranial hemorrhage, radionecrosis) were analyzed using the random-effects model. Results: A total of 16 retrospective studies with 1356 BM patients were included. Compared to noncon-current therapy, concurrent therapy revealed a significantly longer OS (HR= 1.43; p = 0.008) and 12-months LBC (HR = 1.91; p = 0.04), a similar 12-months DBC (HR = 1.12; p = 0.547) and higher complication rate (R = 0.77; p = 0.346). Concurrent therapy leads to a significantly higher OS compared to ICI before SRS (HR = 2.55; p = 0.0003). Conclusion: The combination of SRS with ICI improves patients' clinical and radiological outcomes. The effectiveness of the combination is subject to the identification of an optimal therapeutic window. [ABSTRACT FROM AUTHOR]

By integrating high-performance CT imaging and photothermal therapy (PTT) into one nanoprobe, an effective theranostic can be achieved for clinical cancer treatment. In this study, the graphene quantum dots (GQDs)-coated bismuth (Bi) nanoparticle (NP) as a theranostic nanoprobe is synthesized and its capabilities for computed tomography (CT) imaging and PTT are investigated. Such nanotheranostic exhibits good physiological dispersity with satisfactory blood compatibility and cytotoxicity. Most importantly, the GQDs-Bi NPs offer strong and steady absorbance profile in NIR region with excellent photostability, which can remarkably convert photo-to-thermal with the photothermal efficiency of 30.0%. Thanks to the powerful PTT effect, co-delivery of GQDs-Bi NPs/NIR laser can effectively induce HeLa cells death in vitro. Cooperatively, NPs hold X-ray attenuation coefficient for high-contrast CT imaging with the corresponding CT improvement efficacy as high as 32.7 HU ⋅ mg − 1 . The obtained results highlight the potential of GQDs-Bi NPs as a successful theranostic nanoagent for CT imaging and cancer photothermal therapy. [ABSTRACT FROM AUTHOR]