Table 3.
Update of immunotherapy in NSCLC BM.
| Study | Therapy tested | Control or comparator therapy | Number of patients | Median OS (months) | Median PFS (months) | Other outcomes |
|---|---|---|---|---|---|---|
| Marcus Skribek et al. (85) | ICI | None | 51 | 5.7 | 1.9 | iPFS=2.5months |
| Guowei Zhang et al. (86) | Nivolumab | None | With BM: 32; | 14.8 | 2.8 | ORR=20.0%; DCR=53.1%; DOR=9.8 months |
| Without BM: 41 | 20.2 | 4.9 | ORR=19.5%;DCR=56.1%;DOR=28.8 months; | |||
| Konstantinos Rounis et al. (87) | PD-1/PD-L1 inhibitors | None | 24 | 6.77 | Not reported | Median duration of intracranial response (months): 7.53 Intracranial TTP (months): 4,3 |
| Kazushige Wakuda et al. (88) | Pembrolizumab | None | With BM: 23; | 21.6 | 6.5 | ORR: 57% |
| Without BM: 64; | 24.6 | 7.0 | ORR: 42% | |||
| Sarah B Goldberg et al. (58) | Pembrolizumab | None | 37 | 9.9 | 1.9 | Median TTP=1.8 months; RR=29.7%; |
| Lucio Crinò et al. (89) | Nivolumab | None | 409 | 8.6 | 3.0 | ORR: 17%; DCR: 39%; One year PFS: 20%; One year OS: 43%; |
| Diego Cortinovis et al. (90) | Nivolumab | None | 37 | 5.8 | 4.9 | ORR: 19%; DCR: 49%; OS rate at 1 year: 35%; PFS rate at 1 year: 31%; |
| Clément Gauvain et al. (91) | Nivolumab | None | 43 | Not reached | 3.9 | Intracerebral DCR: 51%; |
| Anna Cho et al. (92) | GKRS + ICI | GKRS alone | GKRS alone: 286; | 5.6 | Not reported | none |
| GKRS+ICI: 82 | 24.2 | |||||
| Matthew J Shepard et al. (93) | ICI+SRS | SRS alone | ICI+SRS: 17 | Not reached | Not reported | 12-month CR: 84.9%; rate of peritumoral edema progression: 11.1% |
| SRS alone: 34 | 15.9 | 12-month CR: 76.3% rate of peritumoral edema progression: 21.7% | ||||
| Charu Singh et al. (94) | anti-PD-1 therapy + SRS (ICI group) | chemotherapy (CT) + SRS (CT group) | ICI group: 39 | 10 | Not reported | Median times to initial response: 49; Median time to maximal response: 105 |
| CT group: 46 | 11.6 | Median times to initial response:84; Median time to maximal response: 182 | ||||
| Linda Chen et al. (95) | SRS + non- concurrent ICI; SRS + Concurrent ICI; | SRS alone | SRS alone: 181 (NSCLC 79%); | 12.9 | 3.7 | Mean number of new metastases: 4 |
| SRS + non- concurrent ICI: 51 (NSCLC 69%); | 14.5 | 2.3 | Mean number of new metastases: 4 | |||
| SRS + Concurrent ICI: 28 (NSCLC 7%); | 24.7 | 2.3 | Mean number of new metastases: 2 | |||
| Chenglong Sun et al. (96) | ICI + chemotherapy; ICI + anti-angiogenic therapy | ICI alone | ICI alone: 30 | 27.43 | Not reported | Combination therapy produced better survivals than monotherapy |
| ICI + chemotherapy: 29 | ||||||
| ICI + anti-angiogenic therapy: 10 | ||||||
| Muhammad Zubair Afzal et al. (97) | carboplatin/pemetrexed plus pembrolizumab (Cohort B) | carboplatin/pemetrexed (Cohort A) | Cohort A: 12 | Not reported | 4.1 | ORR:58.3%; DCR: 75%; Median time to achieve response: 1.67 months; |
| Cohort B: 5 | Not reported | Not reached | ORR:80%; DCR: 80%; Median time to achieve response: 1.1 months; | |||
| Steven F Powell et al. (98) | Pembrolizumab + Platinum-Based Chemotherapy | Chemotherapy alone | Pembrolizumab + chemotherapy: 105 | 18.8 | 6.9 | Incidences of treatment-related adverse events: 88.2% |
| Chemotherapy alone: 66 | 7.6 | 4.1 | Incidences of treatment-related adverse events: 82.8% |
NSCLC, non-small cell lung cancer; BM, brain metastasis; OS, overall survival; PFS, progression-free survival; ICI, immune checkpoint inhibitor; iPFS, intracranial progression-free survival; ORR, objective response rate; DCR, disease control rate; DOR, duration of response; PD-1, programmed death 1; PD-L1, programmed cell death ligand 1; TTP, time to progression; RR, response rate; GKRS, gamma knife radiosurgery; SRS, stereotactic radiation surgery; CR, control rate; DBF, distant brain failure.