Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060

IF 3 Q2 ONCOLOGY
Takehiro Tozuka MD , Yuji Minegishi MD, PhD , Ou Yamaguchi MD, PhD , Kana Watanabe MD , Yukihiro Toi MD , Ryota Saito MD, PhD , Yoshiaki Nagai MD, PhD , Yosuke Tamura MD, PhD , Tetsuaki Shoji MD, PhD , Haruka Odagiri MD , Noriyuki Ebi MD , Kosuke Sakai MD, PhD , Nobuhiro Kanaji MD, PhD , Makoto Izumi MD , Sayo Soda MD, PhD , Satoshi Watanabe MD, PhD , Satoshi Morita PhD , Kunihiko Kobayashi MD, PhD , Masahiro Seike MD, PhD
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引用次数: 0

Abstract

Introduction

Immune checkpoint inhibitor (ICI)–based treatment has become standard treatment for patients with advanced NSCLC. We aimed to determine the survival benefit of upfront radiotherapy for brain metastases (BMs) in patients with NSCLC who received ICI alone (ICI-alone) or with chemotherapy (ICI-chemo).

Methods

This study included consecutive patients with NSCLC having BMs who received ICI alone or ICI-chemo at 50 institutes between February 2017 and September 2021. The presence of BMs was confirmed by imaging before treatment. Treatment outcomes were compared between patients who did and did not receive upfront radiotherapy for BMs. Potential confounding factors were adjusted between the groups through inverse probability treatment weighting (IPTW) analysis and overlap weighting (OW) analysis with propensity scores.

Results

Patients were grouped as ICI-alone cohort, 224 patients (upfront-radiotherapy group, 135 patients; no-radiotherapy group, 89 patients) and ICI-chemo cohort, 367 patients (upfront-radiotherapy group, 212 patients; no-radiotherapy group, 155 patients). In the ICI-alone cohort, the overall survival of the upfront-radiotherapy group was significantly longer than that of the no-radiotherapy group (IPTW-adjusted hazards ratio [HR] = 0.45 [95% confidence interval [CI]: 0.29–0.72], OW-adjusted HR = 0.52 [95% CI: 0.35–0.77]). In contrast, in the ICI-chemo cohort, the OS of the upfront-radiotherapy group was not significantly different from that of the no-radiotherapy group (IPTW-adjusted HR = 1.02 [95% CI: 0.70–1.48], OW-adjusted HR = 0.93 [95% CI: 0.65–1.33]).

Conclusions

Upfront radiotherapy for BMs was associated with longer overall survival in patients with NSCLC who received ICI alone; however, it did not exhibit survival benefits in the patients who received ICI-chemo.

免疫疗法配合放疗治疗 NSCLC 患者的脑转移瘤:NEJ060
简介基于免疫检查点抑制剂(ICI)的治疗已成为晚期NSCLC患者的标准治疗方法。我们旨在确定单独接受ICI治疗(ICI-alone)或联合化疗(ICI-chemo)的NSCLC患者脑转移瘤(BMs)前期放疗的生存获益。治疗前通过影像学检查确认是否存在BMs。比较了因BMs而接受和未接受前期放疗的患者的治疗结果。通过逆概率治疗加权(IPTW)分析和带有倾向分数的重叠加权(OW)分析对各组间的潜在混杂因素进行了调整。结果患者被分为ICI-单独队列224例(前期放疗组,135例;无放疗组,89例)和ICI-化疗队列367例(前期放疗组,212例;无放疗组,155例)。在 ICI 单药队列中,前期放疗组的总生存期明显长于无放疗组(IPTW 调整后的危险比 [HR] = 0.45 [95% 置信区间 [CI]:0.29-0.72],OW 调整后的 HR = 0.52 [95% CI:0.35-0.77])。相比之下,在ICI-化疗队列中,前期放疗组的OS与无放疗组无显著差异(IPTW调整后HR = 1.02 [95% CI: 0.70-1.48],OW调整后HR = 0.93 [95% CI: 0.65-1.33]).结论Upfront放疗治疗BMs与单独接受ICI治疗的NSCLC患者总生存期延长相关;但在接受ICI-化疗的患者中并未表现出生存获益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
145
审稿时长
19 weeks
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