Table 2.
Clinical investigations of ICI and radiotherapy combination in the treatment of NSCLC patients with BMs.
| Data source | Arm (patients with BMs/all patients) | BMs Condition | Response (LNR) | Survival | Safety (≥ 3 Grade AEs) | ||||
|---|---|---|---|---|---|---|---|---|---|
| Experimental | Control | CNS | Systematic | CNS | Systematic | ||||
| Prospective (61) | Concurrent (within 2 weeks) SRT after the first dose of Nivo (26). | N/A | Untreated; ≤ 10 cc; | 80% | 51.7% | iPFS: 5.0m; OS: 14m | NR | NR | |
| Retrospective (62) | RT before or after ICI (545/14090) | RT alone (13545/14090) | NR | NR | NR | OS: 13.1m vs. 9.7m | NR | NR | |
| Retrospective (63) | SRT before or after ICI (within 3 months) (33/77) | SRT alone (44/77) | NR | 97% vs. 86% | NR | OS: HR = 0.46 | NR | NR | |
| Retrospective (64) | Concurrent (within 4 weeks) ICI after SRT (100/150) | SRT alone (50/150) | ≤4 cm; | NR | NR | iPFS: HR = 0.32 | NR | NR | |
| Retrospective (65) | SRT before or after ICI (within 3 months) (17/51) | SRT alone (34/51) | NR | 84.9% vs. 76.3% | NR | NR | 5.9% vs. 2.9% | NR | |
| Retrospective (66) | WBRT before Pembro. (8/30) | SRT before Pembro. (13/30) | Pembro. (9/30) | Asymptomatic | 87.5% vs. 46.2% vs. 66.7% | 87.5% vs. 38.5% vs. 66.7% | iPFS: 7.1m vs. 4.8m vs. nr PFS: 7.1m vs. 3.5m vs. 10.2m | NR | 37.5% vs. 23% vs. 11.1% |
NSCLC, Non-Small Cell Lung Cancer; BMs, Brain Metastases; AEs, Adverse Events; N/A, Not Applicable; NR, Not Reported; nr, Not Reach; HR, Hazard Ratio; ICI, immune checkpoint inhibitor; RT, radiotherapy; SRT, stereotactic radiation therapy; Pembro., Pembrolizumab; Nivo., Nivolumab; OS, Overall Survival; PFS, Progression-free Survival; LCR, local control rate; iPFS, Intracranial Progression-free Survival.