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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Vydáno v:	Current oncology (Toronto) Ročník 31; číslo 3; s. 1656 - 1666
Hlavní autoři:	Nannini, Simon, Guisier, Florian, Curcio, Hubert, Ricordel, Charles, Demontrond, Pierre, Abdallahoui, Safa, Baloglu, Seyyid, Greillier, Laurent, Chouaid, Christos, Schott, Roland
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Switzerland MDPI AG 01.03.2024 MDPI
Témata:	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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Abstract	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.
AbstractList	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. 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.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.
Audience	Academic
Author	Curcio, Hubert Nannini, Simon Ricordel, Charles Greillier, Laurent Demontrond, Pierre Schott, Roland Abdallahoui, Safa Baloglu, Seyyid Guisier, Florian Chouaid, Christos
AuthorAffiliation	1 Department of Oncology, Institut de Cancérologie Strasbourg Europe, 67200 Strasbourg, France; s.nannini@icans.eu (S.N.); s.abdallahoui@icans.eu (S.A.) 7 Department of Pneumology, Centre Hospitalier, 94000 Créteil, France 6 Multidisciplinary Oncology and Therapeutic Innovations, APHM, INSERM, CNRS, CRCM, Hôpital Nord, Aix Marseille University, 13015 Marseille, France 4 Department of Pneumology, Centre Hospitalier Universitaire, 35000 Rennes, France 2 Department of Pneumology, UNIROUEN, LITIS Lab QuantIF Team EA4108, CHU Rouen, Normandie University, Rouen and Inserm CIC-CRB 1404, 76000 Rouen, France 3 Department of Pneumology, Centre Régionale de Lutte Contre le Cancer François Baclesse, 14000 Caen, France 5 Department of Radiological, Centre Hospitalier Universitaire de Strasbourg, 67200 Strasbourg, France
AuthorAffiliation_xml	– name: 4 Department of Pneumology, Centre Hospitalier Universitaire, 35000 Rennes, France – name: 7 Department of Pneumology, Centre Hospitalier, 94000 Créteil, France – name: 1 Department of Oncology, Institut de Cancérologie Strasbourg Europe, 67200 Strasbourg, France; s.nannini@icans.eu (S.N.); s.abdallahoui@icans.eu (S.A.) – name: 2 Department of Pneumology, UNIROUEN, LITIS Lab QuantIF Team EA4108, CHU Rouen, Normandie University, Rouen and Inserm CIC-CRB 1404, 76000 Rouen, France – name: 5 Department of Radiological, Centre Hospitalier Universitaire de Strasbourg, 67200 Strasbourg, France – name: 3 Department of Pneumology, Centre Régionale de Lutte Contre le Cancer François Baclesse, 14000 Caen, France – name: 6 Multidisciplinary Oncology and Therapeutic Innovations, APHM, INSERM, CNRS, CRCM, Hôpital Nord, Aix Marseille University, 13015 Marseille, France
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SubjectTerms	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
Title	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
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