Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060
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...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | JTO Clinical and Research Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666364324000250 |
| _version_ | 1797256258180349952 |
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| author | 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 |
| author_facet | 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 |
| author_sort | Takehiro Tozuka, MD |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T22:18:53Z |
| format | Article |
| id | doaj.art-266c2a21ca60472ab272511e35e74652 |
| institution | Directory Open Access Journal |
| issn | 2666-3643 |
| language | English |
| last_indexed | 2024-04-24T22:18:53Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTO Clinical and Research Reports |
| spelling | doaj.art-266c2a21ca60472ab272511e35e746522024-03-20T06:11:22ZengElsevierJTO Clinical and Research Reports2666-36432024-04-0154100655Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060Takehiro Tozuka, MD0Yuji Minegishi, MD, PhD1Ou Yamaguchi, MD, PhD2Kana Watanabe, MD3Yukihiro Toi, MD4Ryota Saito, MD, PhD5Yoshiaki Nagai, MD, PhD6Yosuke Tamura, MD, PhD7Tetsuaki Shoji, MD, PhD8Haruka Odagiri, MD9Noriyuki Ebi, MD10Kosuke Sakai, MD, PhD11Nobuhiro Kanaji, MD, PhD12Makoto Izumi, MD13Sayo Soda, MD, PhD14Satoshi Watanabe, MD, PhD15Satoshi Morita, PhD16Kunihiko Kobayashi, MD, PhD17Masahiro Seike, MD, PhD18Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, JapanDepartment of Respiratory Medicine, Mitsui. Memorial Hospital, Tokyo, JapanDepartment of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, JapanDepartment of Respiratory Medicine, Miyagi Cancer Center, Miyagi, JapanDepartment of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, JapanDepartment of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanDepartment of Respiratory Medicine, Jichi Medical University, Saitama Medical Center, Saitama, JapanDepartment of Respiratory Medicine and Thoracic Oncology, Osaka Medical and Pharmaceutical University Hospital, Osaka, JapanDepartment of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, JapanDepartment of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, JapanDepartment of Pulmonary Medicine, Saitama Medical Center, Saitama Medical University, Saitama, JapanDepartment of Internal Medicine, Division of Hematology, Rheumatology, and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, JapanDepartment of Chemotherapy, Yokosuka Kyosai Hospital, Kanagawa, JapanDepartment of Pulmonary and Clinical Immunology, Dokkyo Medical University School of Medicine, Tochigi, JapanDepartment of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JapanDepartment of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, JapanDepartment of Respiratory Medicine, Saitama Medical University International Medical Center, Hidaka, Saitama, JapanDepartment of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan; Corresponding author. Address for correspondence: Masahiro Seike MD, PhD, Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.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.http://www.sciencedirect.com/science/article/pii/S2666364324000250ImmunotherapyBrain metastasesNon–small cell lung cancerRadiotherapy |
| spellingShingle | 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 Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060 JTO Clinical and Research Reports Immunotherapy Brain metastases Non–small cell lung cancer Radiotherapy |
| title | Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060 |
| title_full | Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060 |
| title_fullStr | Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060 |
| title_full_unstemmed | Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060 |
| title_short | Immunotherapy With Radiotherapy for Brain Metastases in Patients With NSCLC: NEJ060 |
| title_sort | immunotherapy with radiotherapy for brain metastases in patients with nsclc nej060 |
| topic | Immunotherapy Brain metastases Non–small cell lung cancer Radiotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2666364324000250 |
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