Efficacy of Pembrolizumab Monotherapy in Patients With or Without Brain Metastases From Advanced Non–Small Cell Lung Cancer With a PD-L1 Expression ≥50%. Issue 9 (November 2020)

• Record Type: Journal Article
• Authors: Metro, Giulio; Banna, Giuseppe Luigi; Signorelli, Diego; Gili, Alessio; Galetta, Domenico; Galli, Giulia; Economopoulou, Panagiota; Roila, Fausto; Friedlaender, Alex; Camerini, Andrea; Christopoulou, Athina; Cantale, Ornella; De Toma, Alessandro; Pizzutilo, Pamela; Jimenez, Beatriz; Collazo-Lorduy, Ana; Calles, Antonio; Baxevanos, Panagiotis; Linardou, Helena; Kosmidis, Paris; Giannarelli, Diana; Mountzios, Giannis; Addeo, Alfredo
• Is Part Of: Journal of immunotherapy. Volume 43:Issue 9(2020:Nov./Dec.)
• Publication Date: 2020-11
• Subjects: brain metastases -- immunotherapy -- non–small cell lung cancer -- PD-L1≥50% -- pembrolizumab; Immunotherapy -- Periodicals; Immunotherapy -- Periodicals; Neoplasms -- therapy -- Periodicals; Electronic journals; Electronic journals; 615.37
• DOI: 10.1097/CJI.0000000000000340
• Languages: English
• ISSNs: 1524-9557

Abstract

Abstract : The authors conducted a multicenter retrospective study on the outcome of programmed death-ligand 1 tumor proportion score≥50% advanced non–small cell lung cancer patients treated with first-line pembrolizumab according to the presence/absence of brain metastases. A total of 282 patients were included, of whom 56 had brain metastases that were treated with upfront local radiation therapy in 80.3% of cases. The overall response rate was 39.2% and 44.4% in patients with and without brain metastases ( P =0.48), respectively, while intracranial response rate and intracranial disease control rate were 67.5% and 85.0%, respectively. The median time-to-treatment failure (TTF) and overall survival (OS) were 4.2 and 9.9 months versus 10.8 and 26.5 months for patients with and without brain metastases ( P =0.06 and 0.05, respectively). Drug discontinuation rate due to treatment-related adverse events was 10.7% and 10.2% in patients with and without brain metastases, respectively. Multivariate analysis showed that baseline steroids was an independent predictor for a worse OS ( P <0.001), while performance status (PS)≥2 was an independent predictor for a poorer TTF ( P <0.001) and OS ( P <0.001). In patients with brain metastases, only PS ≥2 was predicted for a worse TTF ( P =0.02) and OS ( P =0.03). Pembrolizumab has activity against brain metastases from non–small cell lung cancers with programmed death-ligand 1≥50%. Presence of brain metastases per se does not appear to be prognostic, and PS ≥2 seems to be the only factor associated with a worse outcome in patients with brain metastases. Abstract : Supplemental Digital Content is available in the text.