Evidence map›Paper›PMID 33415659›Full record

ArticleJournal of neuro-oncology2021

Improved survival and disease control following pembrolizumab-induced immune-related adverse events in high PD-L1 expressing non-small cell lung cancer with brain metastases.

Michael Zhang, Adrian J Rodrigues, Erqi L Pollom, Iris C Gibbs, Scott G Soltys, Steven L Hancock, Joel W Neal, Sukhmani K Padda, Kavitha J Ramchandran, Heather A Wakelee and 4 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Systemic Therapy for Lung Cancer Brain Metastases.Current treatment options in oncology · 2021
    Review
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Michael Zhang *Department of Neurosurgery, Stanford Medical Center, Palo Alto, CA, 94304, USA.ORCID http://orcid.org/0000-0002-7067-0689
Adrian J Rodrigues *Department of Neurosurgery, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Erqi L PollomDepartment of Radiation Oncology, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Iris C GibbsDepartment of Radiation Oncology, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Scott G SoltysDepartment of Radiation Oncology, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Steven L HancockDepartment of Radiation Oncology, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Joel W NealDepartment of Medicine, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Sukhmani K PaddaDepartment of Medicine, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Kavitha J RamchandranDepartment of Medicine, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Heather A WakeleeDepartment of Medicine, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Steven D ChangDepartment of Neurosurgery, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Michael LimDepartment of Neurosurgery, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Melanie Hayden GephartDepartment of Neurosurgery, Stanford Medical Center, Palo Alto, CA, 94304, USA.
Gordon LiDepartment of Neurosurgery, Stanford Medical Center, Palo Alto, CA, 94304, USA. gordonli@stanford.edu.
Stanford Medicine · US

Funding

STANFORD CANCER IMAGING TRAINING (SCIT) PROGRAMT32CA009695 · NCI · STANFORD UNIVERSITY · PI BRUCE L DANIEL, Jeremy Dahl · 1993 to 2026
$7.7M
NCI NIH HHS T32 CA009695
6 · The paper itself

Abstract

introductionImmune checkpoint inhibitors have become standard of care for many patients with non-small cell lung cancer (NSCLC). These agents often cause immune-related adverse events (IRAEs), which have been associated with increased overall survival (OS). Intracranial disease control and OS for patients experiencing IRAEs with metastatic NSCLC and brain metastases have not yet been described.

methodsWe performed a single-institution, retrospective review of patients with NSCLC and existing diagnosis of brain metastasis, who underwent pembrolizumab treatment and developed any grade IRAE. The primary outcome of the study was intracranial time to treatment failure (TTF), defined from time of pembrolizumab initiation to new intracranial disease progression or death. Kaplan-Meier and Cox proportional hazard analyses were performed.

resultsA total of 63 patients with NSCLC brain metastasis were identified, and 24 developed IRAEs. Patients with any grade IRAEs had longer OS (21 vs. 10 months, p = 0.004), systemic TTF (15 vs. 4 months, p < 0.001) and intracranial TTF (14 vs. 5 months, p = 0.001), relative to patients without IRAEs. Presence of IRAEs and high PD-L1 (≥ 50%), but not absent/moderate PD-L1 (0-49%), had a positive association for OS, systemic TTF, and intracranial TTF. Following multivariable analysis, IRAE experienced on pembrolizumab was an independent predictor of OS, systemic TTF, and intracranial TTF.

conclusionsIn our series of patients with NSCLC and brain metastases treated with pembrolizumab, IRAE presence was associated with a significant increase in OS, systemic TTF, and intracranial TTF. Future studies with increased cohorts will clarify how IRAEs should be interpreted among molecular subtypes.

Indexed as

Drug-Related Side Effects and Adverse ReactionsAdultAgedAged, 80 and overAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalB7-H1 AntigenBrain NeoplasmsCarcinoma, Non-Small-Cell LungDisease ProgressionFemaleHumansImmune System DiseasesImmunotherapyKaplan-Meier EstimateLung NeoplasmsAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalB7-H1 AntigenCD274 protein, humanpembrolizumabBrain metastasisImmune-related adverse eventsImmunotherapyNon-small cell lung cancerPembrolizumabProgression

Identifiers

PMID33415659
PMCPMC8214448
OpenAlexW3120695710

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.