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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 :
Sora Kang
Hyehyun Jeong
Ji Eun Park
Ho Sung Kim
Young-Hoon Kim
Dae Ho Lee
Sang-We Kim
Jae Cheol Lee
Chang Min Choi
Shinkyo Yoon
Source :
Journal of Cancer Research and Clinical Oncology.
Publication Year :
2022
Publisher :
Springer Science and Business Media LLC, 2022.

Abstract

Purposes: 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. 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). 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% (n = 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. 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.

Details

ISSN :
14321335 and 01715216
Database :
OpenAIRE
Journal :
Journal of Cancer Research and Clinical Oncology
Accession number :
edsair.doi.dedup.....5c836bbff8d99696264349080367fa4d
Full Text :
https://doi.org/10.1007/s00432-022-04251-3