Upfront immunotherapy leads to lower brain metastasis velocity in patients undergoing stereotactic radiosurgery for brain metastases.

Autor:	Abdulhaleem M; Department of Medicine, Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Scott E; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Johnston H; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Isom S; Deparment of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA., Lanier C; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA., LeCompte M; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA., Cramer CK; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Ruiz J; Department of Medicine, Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Lo HW; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Watabe K; Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA., O'Neill S; Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Whitlow C; Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, USA., Tatter SB; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA., W Laxton A; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA., Su J; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA., Chan MD; Department of Radiation Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Jazyk:	angličtina
Zdroj:	Journal of radiosurgery and SBRT [J Radiosurg SBRT] 2022; Vol. 8 (2), pp. 77-83.
Abstrakt:	Background: While immunotherapy has been shown to improve survival and decrease neurologic death in patients with brain metastases, it remains unclear whether this improvement is due to prevention of new metastasis to the brain. Method: We performed a retrospective review of patients presenting with brain metastases simultaneously with the first diagnosis of metastatic disease and were treated with upfront immunotherapy as part of their treatment regimen and stereotactic radiosurgery (SRS) to the brain metastases. We compared this cohort with a historical control population (prior to the immunotherapy era) who were treated with pre-immunotherapy standard of care systemic therapy and with SRS to the brain metastases. Results: Median overall survival time was improved in the patients receiving upfront immunotherapy compared to the historical cohort (48 months vs 8.4 months, p=0.001). Median time to distant brain failure was statistically equivalent (p=0.3) between the upfront immunotherapy cohort and historical control cohort (10.3 vs 12.6 months). Brain metastasis velocity was lower in the upfront immunotherapy cohort (median 3.72 metastases per year) than in the historical controls (median 9.48 metastases per year, p=0.001). Cumulative incidence of neurologic death at one year was 12% in the upfront immunotherapy cohort and 28% in the historical control cohort (p=0.1). Conclusions: Upfront immunotherapy appears to improve overall survival and decrease BMV compared to historical controls. While these data remain to be validated, they suggest that brain metastasis patients may benefit from concurrent immunotherapy with SRS. (© 2022 Old City Publishing, Inc.)
Databáze:	MEDLINE
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