Oncology Research and Treatment
Nieder C. · Mannsåker B. · Stanisavljevic L. ·
Haukland E.
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Article / Publication Details
Abstract
Introduction: Immune checkpoint inhibitors (ICI) have become a mainstay of treatment for different cancer types. The purpose of this study was to evaluate patterns of care and overall survival after diagnosis of brain metastases in patients managed with ICI as component of care.
Methods: Retrospective cohort study. Fifty patients were included (34 with brain metastases at first cancer diagnosis, 16 with metachronous spread).
Results: Depending on symptoms, lesion number and size, and other individualized criteria, multidisciplinary tumor board (MDT) discussion resulted in highly individualized treatment sequences. Selected patients received systemic treatment alone. Twenty-four patients (48%) had any stereotactic radiosurgery (SRS) or neurosurgical resection at some point in time (upfront/salvage). Only 7 patients (14%) were never treated with brain irradiation or neurosurgery. Median overall survival (OS) was 13.0 months. Better Karnofsky performance status (KPS), absence of extracranial metastases, and time interval between cancer diagnosis and brain metastases of 0-18 months predicted for improved survival. Treatment sequence was not associated with survival. Patients without extracranial metastases had median OS of 52.2 months.
Discussion/Conclusion: Long-term survival is possible in patients managed with ICI ± brain-directed treatment. This study did not identify a clear treatment sequence of choice. MDT assessment at diagnosis and each progression is recommended to ensure favorable outcomes.
S. Karger AG, Basel
Article / Publication Details
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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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