Cancer treatment and research communications · 2025
A retrospective analysis of the efficacy and safety of immune combination therapy in driver gene-negative non-small cell lung cancer with brain metastases.
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Li Kuo, Wang Bingxiang, Liu Shuaishuai, Li Cheng, Cui Hongxia, Qi Zhenli, Sun Guanxing, Zheng Xin, Gao Min
Аннотация
PURPOSE: Central nervous system metastases, significantly worsen the prognosis of driver gene-negative non-small cell lung cancer (NSCLC) patients. This study aims to evaluate the efficacy and safety of immunotherapy in driver gene-negative NSCLC patients with brain metastases (BMs).
METHOD: A retrospective analysis was conducted on 244 driver gene-negative NSCLC patients with BMs treated at Shandong Cancer Hospital between August 2019 and December 2023. Patients received immunotherapy (camrelizumab, tislelizumab, sintilimab, pembrolizumab) alone or in combination with radiotherapy. Efficacy endpoints included intracranial objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS), assessed using RECIST 1.1 and RANO criteria. Statistical analyses were performed using Kaplan-Meier methods.
RESULT: The intracranial ORR and DCR were 53.3 % and 89.4 %, respectively. The median PFS and OS were 18.0 and 49.0 months, with a 2-year OS rate of 78.8 %. Combined radiotherapy improved short-term PFS (17.0 vs. 21.0 months, P=0.265) but not OS (P=0.656). Camrelizumab demonstrated a superior median PFS (28.0 months) compared to other agents (P=0.0044). Concurrent radiotherapy timing yielded the highest survival outcomes (PFS: 18.0 months; OS: 59.0 months).
CONCLUSION: Immunotherapy shows robust efficacy in driver gene-negative NSCLC with brain metastases, particularly for intracranial control. Camrelizumab outperformed other ICIs, and concurrent radiotherapy provided transient PFS benefits without OS improvement. These findings highlight the potential of immunotherapy as a cornerstone therapy, warranting further exploration of combination strategies and biomarker-driven approaches.
METHOD: A retrospective analysis was conducted on 244 driver gene-negative NSCLC patients with BMs treated at Shandong Cancer Hospital between August 2019 and December 2023. Patients received immunotherapy (camrelizumab, tislelizumab, sintilimab, pembrolizumab) alone or in combination with radiotherapy. Efficacy endpoints included intracranial objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS), assessed using RECIST 1.1 and RANO criteria. Statistical analyses were performed using Kaplan-Meier methods.
RESULT: The intracranial ORR and DCR were 53.3 % and 89.4 %, respectively. The median PFS and OS were 18.0 and 49.0 months, with a 2-year OS rate of 78.8 %. Combined radiotherapy improved short-term PFS (17.0 vs. 21.0 months, P=0.265) but not OS (P=0.656). Camrelizumab demonstrated a superior median PFS (28.0 months) compared to other agents (P=0.0044). Concurrent radiotherapy timing yielded the highest survival outcomes (PFS: 18.0 months; OS: 59.0 months).
CONCLUSION: Immunotherapy shows robust efficacy in driver gene-negative NSCLC with brain metastases, particularly for intracranial control. Camrelizumab outperformed other ICIs, and concurrent radiotherapy provided transient PFS benefits without OS improvement. These findings highlight the potential of immunotherapy as a cornerstone therapy, warranting further exploration of combination strategies and biomarker-driven approaches.