Intracranial efficacy of combined immune checkpoint inhibitors and platinum plus etoposide therapy in patients with extensive-disease small-cell lung cancer and brain metastases

IF 3.5 Q3 Medicine

Cancer treatment and research communications Pub Date : 2026-01-01 Epub Date: 2026-05-14 DOI:10.1016/j.ctarc.2026.101249

Kenta Nakamura , Toshihiro Shiozawa , Hiroaki Tachi , Jun Kanazawa , Takeshi Numata , Tomohiro Tamura , Shigen Hayashi , Tomoyuki Ogata , Kunihiko Miyazaki , Norihiro Kikuchi , Koichi Kurishima , Hiroaki Satoh , Nobuyuki Hizawa

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引用次数: 0

Abstract

Background

The management of brain metastases remains a major challenge in extensive-disease small-cell lung cancer (ED-SCLC). Although immune checkpoint inhibitor (ICI) therapy combined with etoposide and platinum (EP) is the standard treatment for ED-SCLC, its intracranial efficacy remains unclear. This study evaluated the efficacy of combined ICI and EP therapy, with a focus on intracranial response.

Methods

We retrospectively included 59 patients with ED-SCLC and brain metastases who received combined ICI and EP therapy. Efficacy endpoints included objective response rates (ORRs), progression-free survival (PFS), and overall survival (OS). The ORR and PFS were evaluated separately for intracranial (i) and extracranial (e) lesions. We also evaluated survival according to upfront brain radiotherapy (BRT) use prior to systemic chemotherapy.

Results

Patients with a performance status of 2 or 3 accounted for 27 % of the cohort. Nineteen patients (32 %) had symptomatic brain metastases. The iORR and eORR were 73 % and 78 %, respectively (p = 0.42). The median iPFS was 6.3 months (95 % confidence intervals [CI]: 4.5–8.0), comparable to the median ePFS of 5.2 months (95 % CI: 4.0–6.4). In survival analyses by upfront BRT, the median iPFS was numerically longer in the BRT group than in the non-BRT group (9.7 vs. 5.7 months, p = 0.09). The median OS did not differ significantly between the BRT and non-BRT groups (11.6 months vs. 10.9 months; p = 0.26).

Conclusion

Combined ICI and EP therapy demonstrated favorable intracranial efficacy. OS was similar regardless of upfront BRT, supporting this regimen as a valuable treatment option for ED-SCLC with brain metastases.

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免疫检查点抑制剂联合铂+依托泊苷治疗广泛性小细胞肺癌和脑转移患者的颅内疗效

背景：脑转移的处理仍然是广泛病变小细胞肺癌（ED-SCLC）的主要挑战。尽管免疫检查点抑制剂（ICI）联合依托泊苷和铂（EP）是ED-SCLC的标准治疗方法，但其颅内疗效尚不清楚。本研究评估了ICI和EP联合治疗的疗效，重点关注颅内反应。方法：我们回顾性地纳入59例ED-SCLC合并脑转移的患者，这些患者接受了ICI和EP联合治疗。疗效终点包括客观缓解率（ORRs）、无进展生存期（PFS）和总生存期（OS）。ORR和PFS分别对颅内(i)和颅外(e)病变进行评估。我们还根据全身化疗前的前期脑放疗（BRT）使用来评估生存率。结果：表现状态为2或3的患者占队列的27%。19例（32%）有症状性脑转移。iORR为73%，eORR为78% （p = 0.42）。中位iPFS为6.3个月（95%置信区间[CI]: 4.5-8.0），与中位ePFS为5.2个月（95% CI: 4.0-6.4）相当。在通过前期BRT进行的生存分析中，BRT组的中位iPFS在数值上长于非BRT组（9.7个月对5.7个月，p = 0.09）。BRT组和非BRT组的中位OS无显著差异（11.6个月vs 10.9个月；p = 0.26）。结论：ICI联合EP治疗颅内疗效良好。无论是否进行BRT治疗，总OS相似，支持该方案作为ED-SCLC伴脑转移的有价值的治疗选择。

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

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.