Therapeutic effectiveness and safety of sequential ICIs with radiotherapy for symptomatic brain and bone metastases in NSCLC patients

作者全名："Tang, Cuiping; Qin, Si; Li, Qian; Huang, Yusheng"

作者地址："[Tang, Cuiping] Chongqing Med Univ, Clin Coll 2, Chongqing, Peoples R China; [Tang, Cuiping; Huang, Yusheng] Chongqing Med Univ, Dept Oncol, Affiliated Hosp 2, Chongqing, Peoples R China; [Qin, Si] Army Mil Med Univ, Xinqiao Hosp, Dept Oncol, Chongqing, Peoples R China; [Li, Qian] Army Mil Med Univ, Southwest Hosp, Dept Pathol, Chongqing, Peoples R China"

通信作者："Huang, YS (通讯作者)，Chongqing Med Univ, Dept Oncol, Affiliated Hosp 2, 288 Tianwen Ave, Chongqing 400010, Peoples R China."

来源：MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000890207100125

JCR分区：Q2

影响因子：1.6

年份：2022

卷号：101

期号：46

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结束页：　

文献类型：Article

关键词：bone metastasis; brain metastasis; ICIs; NSCLC; radiotherapy

摘要："In advanced non-small cell lung cancer (NSCLC), the brain and bones are common metastatic sites, and the disease seriously affects the survival time and quality of life. For metastatic lesions with symptoms, local treatment often precedes systemic treatment. However, in clinical trials, patients with symptomatic brain or bone metastases are often excluded. Therefore, limited data are available on the efficacy of immune checkpoint inhibitors (ICIs) in those patients. We aimed to evaluate the effectiveness and safety of local radiotherapy followed by ICIs in driver gene-negative NSCLC patients with symptomatic local metastasis in the brain and bone. This is a 29-month 2 centered retrospective cohort study performed in China between March 2019 and August 2021. A total of 22 patients with advanced NSCLC were included. All patients received radiotherapy in the brain or bone before the administration of ICIs. For all patients, the overall response rate was 59.09%, the median progression-free survival (PFS) was 7.5 months, the PFS rate at 6 months was 72.73%, and the PFS rate at 1 year was 13.64%. Waterfall plots showed that tumor size was mostly reduced compared with baseline. The spider map showed that the tumor continued to shrink. In terms of symptom improvement, 100% pain control and 83.33% improvement were observed in epilepsy and neurological function. Sequential ICIs with local radiotherapy is effective for the treatment of patients with symptomatic brain and bone metastases of driver gene-negative NSCLC, which will benefit patients and improve their symptoms."

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