PMID- 34284948
OWN - NLM
STAT- MEDLINE
DCOM- 20220317
LR  - 20220317
IS  - 1938-0690 (Electronic)
IS  - 1525-7304 (Linking)
VI  - 23
IP  - 2
DP  - 2022 Mar
TI  - Efficacy and Safety of Combined Brain Radiotherapy and Immunotherapy in 
      Non-Small-Cell Lung Cancer With Brain Metastases: A Systematic Review and 
      Meta-Analysis.
PG  - 95-107
LID - S1525-7304(21)00160-1 [pii]
LID - 10.1016/j.cllc.2021.06.009 [doi]
AB  - BACKGROUND: Immune checkpoint inhibitors (ICIs) are recommended to treat advanced 
      non-small-cell lung cancer (NSCLC), whereas brain radiotherapy (RT) is the 
      mainstream therapy for patients with brain metastases (BMs). This systematic 
      review and meta-analysis investigated whether the combination of brain RT and 
      ICIs would generate a synergistic effect without unacceptable toxicity to treat 
      NSCLC with BMs. METHODS: Literature searching was performed in PubMed, Embase, 
      Web Of Science, and The Cochrane Library up to December 20, 2020. Heterogeneity, 
      sensitivity analysis, forest plots, and publication bias were analyzed using 
      Stata 15.0. RESULTS: Nineteen studies were included. In the comparison of the 
      brain RT+ICIs arm and brain RT alone arm, the pooled effect size (ES) for overall 
      survival (OS) (hazard ratio [HR] = 0.77; 95% confidence interval [CI] 0.71-0.83; 
      I(2) = 0; P < .001; n = 4) and grade 3-4 neurological adverse events (AEs) (risk 
      ratio [RR] = 0.91; 95% CI 0.41-2.02; I(2) = 26.5; P = .809; n = 4) indicated that 
      the brain RT+ICIs model had significantly better systemic efficacy and similar 
      neurological AEs compared with brain RT alone for NSCLC. Concurrent RT+ICIs were 
      identified as the optimal model, which achieved the best efficacy without 
      significantly increased AEs compared with sequential RT+ICIs. CONCLUSIONS: 
      Combined ICIs and brain RT exhibited favorable efficacy and acceptable toxicity 
      for NSCLC patients with BMs, among which, the concurrent model might be the 
      optimal option. Our results could guide the design of future randomized 
      controlled trials and clinical practice.
CI  - Copyright (c) 2021 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Yang, Yin
AU  - Yang Y
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Chaoyang, Beijing, China.
FAU - Deng, Lei
AU  - Deng L
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Chaoyang, Beijing, China.
FAU - Yang, Yufan
AU  - Yang Y
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Chaoyang, Beijing, China.
FAU - Zhang, Tao
AU  - Zhang T
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Chaoyang, Beijing, China.
FAU - Wu, Yuqi
AU  - Wu Y
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Chaoyang, Beijing, China.
FAU - Wang, Luhua
AU  - Wang L
AD  - Department of Radiation Oncology, National Cancer Center/ Cancer Hospital & 
      Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical 
      College, Shenzhen, Guangdong Province, China. Electronic address: 
      wlhwq@yahoo.com.
FAU - Bi, Nan
AU  - Bi N
AD  - Department of Radiation Oncology, National Cancer Center/National Clinical 
      Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences 
      and Peking Union Medical College, Chaoyang, Beijing, China. Electronic address: 
      binan_email@163.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20210624
PL  - United States
TA  - Clin Lung Cancer
JT  - Clinical lung cancer
JID - 100893225
RN  - 0 (Immune Checkpoint Inhibitors)
SB  - IM
MH  - Brain Neoplasms/secondary/*surgery
MH  - Carcinoma, Non-Small-Cell Lung/*therapy
MH  - Humans
MH  - *Immune Checkpoint Inhibitors
MH  - Immunotherapy/*methods
MH  - Lung Neoplasms/pathology/*therapy
MH  - Survival Analysis
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Advanced non-small-cell lung cancer
OT  - Brain radiotherapy
OT  - Combined therapy
OT  - Immune checkpoint inhibitors
EDAT- 2021/07/22 06:00
MHDA- 2022/03/18 06:00
CRDT- 2021/07/21 05:43
PHST- 2021/02/09 00:00 [received]
PHST- 2021/06/03 00:00 [revised]
PHST- 2021/06/16 00:00 [accepted]
PHST- 2021/07/22 06:00 [pubmed]
PHST- 2022/03/18 06:00 [medline]
PHST- 2021/07/21 05:43 [entrez]
AID - S1525-7304(21)00160-1 [pii]
AID - 10.1016/j.cllc.2021.06.009 [doi]
PST - ppublish
SO  - Clin Lung Cancer. 2022 Mar;23(2):95-107. doi: 10.1016/j.cllc.2021.06.009. Epub 
      2021 Jun 24.