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Do Brain Metastases Affect Outcomes With Immunotherapy?

By: Kayci Reyer
Posted: Tuesday, October 30, 2018

Immune checkpoint inhibitor therapy does not seem to be negatively impacted by the presence of brain metastases in patients with non–small cell lung cancer (NSCLC), according to research recently presented at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) in Toronto (Abstract MA08.09) and published in the Journal of Thoracic Oncology. Lizza Hendriks, MD, of the Maastricht University Medical Center, and colleagues sought to determine progression-free and overall survival in patients with brain metastases undergoing immunotherapy.

The study, which drew data from all patients with NSCLC on immune checkpoint inhibitor therapy in 6 facilities between November 2012 and March 2018, included 945 individuals. A total of 241 of them had brain metastases. Of those patients, 40% had active brain metastases, and 68% had undergone previous cranial irradiation. Compared with the group at large, patients with brain metastases were younger (61 years vs. 66 years), had more adenocarcinoma (78% vs. 62%), and had more organs involved (median 3 vs. 2). Most participants (94%) received monotherapy PD-L1 inhibition.

At a follow-up of 15 months, median progression-free survival for those with brain metastases was 2 months (1–2 months) versus 2 months (2–3 months) for those without. Median overall survival was 9 months (7–13 months) for those with brain metastases and 13 months (9–16 months) for those without. Univariate analysis of participants showed active brain metastases were associated with no worse outcomes than those that were stable.

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