Outcomes of Patients with Non-Small Cell Lung Cancer and Brain Metastases Treated with the Upfront Single Agent Pembrolizumab: A Retrospective and Multicentric Study of the ESCKEYP GFPC Cohort

Non-small cell lung cancer (NSCLC) is the most common cause of brain metastasis (BM). Little is known about immune checkpoint inhibitor activity in the central nervous system, especially in patients receiving monotherapy for tumors with a tumor proportion score (TPS) ≥ 50%. This noninterventional, r...

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Veröffentlicht in:Current oncology (Toronto) Jg. 31; H. 3; S. 1656 - 1666
Hauptverfasser: Nannini, Simon, Guisier, Florian, Curcio, Hubert, Ricordel, Charles, Demontrond, Pierre, Abdallahoui, Safa, Baloglu, Seyyid, Greillier, Laurent, Chouaid, Christos, Schott, Roland
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Switzerland MDPI AG 01.03.2024
MDPI
Schlagworte:
Antibodies, Monoclonal, Humanized
Antineoplastic Agents, Immunological - therapeutic use
Brain
brain metastasis
Brain Neoplasms
Carcinoma, Non-Small-Cell Lung - drug therapy
Care and treatment
central nervous system
Development and progression
Humans
immunotherapy
Lung cancer, Non-small cell
Lung cancer, Small cell
Lung Neoplasms - drug therapy
Metastasis
non-small cell lung cancer
Patient outcomes
Pharmaceutical industry
Radiotherapy
real-life data
Retrospective Studies
France
United States
non-small cell lung cancer
brain metastasis
real-life data
immunotherapy
central nervous system
ISSN:1718-7729, 1198-0052, 1718-7729
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Zusammenfassung:Non-small cell lung cancer (NSCLC) is the most common cause of brain metastasis (BM). Little is known about immune checkpoint inhibitor activity in the central nervous system, especially in patients receiving monotherapy for tumors with a tumor proportion score (TPS) ≥ 50%. This noninterventional, retrospective, multicenter study, conducted with the GFPC, included treatment-naïve patients strongly positive for PD-L1 (TPS ≥ 50%) with BM receiving first-line single-agent pembrolizumab treatment between May 2017 and November 2019. The primary endpoints were centrally reviewed intracranial overall response rates (ORRs), centrally reviewed intracranial progression-free survival (cPFS), extracranial PFS, and overall survival were secondary endpoints. Forty-three patients from five centers were included. Surgical or local radiation therapy was administered to 31 (72%) patients, mostly before initiating ICI therapy (25/31). Among 38/43 (88.4%) evaluable patients, the intracranial ORR was 73%. The median PFS was 8.3 months. The cerebral and extracerebral median PFS times were 9.2 and 5.3 months, respectively. The median OS was 25.5 months. According to multivariate analysis, BM surgery before ICI therapy was the only factor significantly associated with both improved PFS (HR = 0.44) and OS (HR = 0.45). This study revealed the feasibility and outcome of front-line pembrolizumab treatment in this population with BM.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1718-7729
1198-0052
1718-7729
DOI:10.3390/curroncol31030126