NSCLC brain metastasis: adding checkpoint inhibitors to SRS fails to boost survival

  • Shepard MJ & al.
  • J Neurosurg
  • 26 Jul 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • The use of immune checkpoint inhibitors (ICIs) concurrently with stereotactic radiosurgery (SRS) for brain metastases (BMs) in patients with NSCLC offered no survival advantage compared with SRS alone, but concurrent treatment did yield a higher complete response rate.

Why this matters

  • About half of patients with NSCLC develop BMs, but patients with untreated BMs were excluded from clinical trials on which FDA approvals were based.

Study design

  • 51 patients with NSCLC who underwent SRS for BMs received concurrent ICIs (n=17) or no ICIs (n=34).
  • Funding: None disclosed.

Key results

  • No significant difference between groups in OS, intracranial PFS, individual tumor control rate.
  • 12-month local control rate was similar between groups, but concurrent ICI group had a significantly higher rate of complete response for SRS-treated BMs than the ICI-naive group (50% vs 15.6%; P=.012).
  • Median time to tumor regression was shorter in the concurrent ICI group than the ICI-naive group (2.5 vs 3.1 months; P<.0001>
  • No increase in SRS adverse events noted with ICI use.

Limitations

  • Single-center, retrospective study.

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