Survival benefits of concurrent immune checkpoint inhibitor and radiotherapy in non-small cell lung cancer with brain metastases

BACKGROUND The optimal sequencing of immune checkpoint inhibitor (ICI) and brain radiotherapy in the management of brain metastasis from non-small cell lung cancer (NSCLC) is unclear. AIM To evaluate the survival of concurrent ICI and consolidation ICI in NSCLC patients treated with brain radiotherapy. METHODS We retrospectively analyzed NSCLC patients treated with brain radiotherapy and ICI. Treatment response and survival were estimated. The cox proportional hazards regression model was utilized to investigate the association between overall survival and clinical variables. RESULTS There were 54 patients in concurrent ICI and radiotherapy group, and 62 individuals treated with radiotherapy followed by consolidation ICI. The objective response rates were similar between the two group. The median progression free survival was significantly high in the concurrent ICI group compared with consolidation ICI group (9.56 months vs 8.15 months, P = 0.038). In addition, the median overall survival was 22.08 months in the concurrent ICI group, clearly longer than that in the consolidation group (13.24 months, P = 0.009). CONCLUSION In NSCLC patients with brain metastases, our analyses suggested that radiotherapy concurrent with ICI was associated with significant benefit compared with radiotherapy followed by consolidation ICI.