Background: Immune checkpoint inhibitors (ICI)s were recently approved\nfor the treatment of advanced non-small cell lung cancer (NSCLC). Whereas\nbrain metastases (BM) are frequent in NSCLC patients, data are missing regarding\nICIs intracranial efficacy and tolerance in patients with BM from\nNSCLC. Methods: This retrospective study was performed in the Multidisciplinary\nOncology and Therapeutic Innovation department, Marseille, France\nbetween April 2013 and February 2016. Data from patients with NSCLC with at\nleast one BM, and treated with ICIs (anti-PD1, anti-PDL1 or anti-CTL4) were\nanalyzed. Clinical, biological data and outcomes were retrieved from electronic\npatientsâ?? records. We assessed ICIs intracranial efficacy and tolerance.\nResults: Data from 55 patients were analyzed. Objective Response Rate\n(ORR) and Disease Control Rate (DCR) were respectively of 1.8 and 36.4%.\nMedian overall survival was 17.2 months and median progression free survival\nwas 2.9 months. Intracranial ORR (icORR) and intracranial DCR (icDCR)\nwere respectively 16.4% and 45.5%. Both were independent of smoking status,\nintracranial treatment, performance status, pathology, molecular profile\nand the presence or number of BM at diagnosis. However, there was a trend\ntowards an association between icORR and ECOG PS (p = 0.05), tobacco status\n(p = 0.057) and intracranial treatment. Adverse events were seen in 38.2%\npatients without identified predictive factor. Neurological symptoms appeared\nin 5.5% patients during immunotherapy and improved in 3.63% patients. \nConclusions: ICIs can be used safely on patients with BM from\nNSCLC. However, intracranial response is heterogeneous in such patients\nand we showed ECOG PS, tobacco smoking and intracranial treatment to be\nassociated with an improved icORR. This is the first study looking for predictive\nfactors of intracranial response of ICIs in patients with BM from NSCLC.
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