SynthesisNeuro-oncology2021
The combined use of steroids and immune checkpoint inhibitors in brain metastasis patients: a systematic review and meta-analysis.
Synthesis in Neuro-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 5 of them syntheses that pooled it.
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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.
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.
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Who cites it
43 citing papers in PubMed, 5 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Resection of brain radionecrosis after stereotactic radiosurgery or radiotherapy: a meta-analysis.Neurosurgical review · 2026Pooled it
- Impact of concomitant medications on the efficacy of immune checkpoint inhibitors: an umbrella review.Frontiers in immunology · 2023Pooled it
- Adverse events of neoadjuvant combination immunotherapy for resectable cancer patients: a systematic review and meta-analysis.Frontiers in immunology · 2023Pooled it
- The Long-Term and Short-Term Efficacy of Immunotherapy in Non-Small Cell Lung Cancer Patients With Brain Metastases: A Systematic Review and Meta-Analysis.Frontiers in immunology · 2022Pooled it
- The Role of Immune Checkpoint Inhibitors in Leptomeningeal Disease: A Systematic Review.Anticancer research · 2021Pooled it
- The threefold value of surgery in previously irradiated brain metastases.Journal of neuro-oncology · 2026Article
- Serum lactate dehydrogenase is associated with the presence and extent of preoperative peritumoral edema in melanoma brain metastases.Journal of neuro-oncology · 2026Article
- Evidence-based supportive care for patients undergoing radiotherapy: Recommendations from the updated German national S3 guideline for oncological patients.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Systemic Glucocorticoid Immunosuppression and Survival Among Immune Checkpoint Inhibitor Recipients.JAMA network open · 2026Article
- Evaluating the Therapeutic Impact of Immune Checkpoint Inhibitors in the Management of Brain Metastases from Non-Small Cell Lung Cancer.Biomedicines · 2026Review
- Bacteria-related signals in brain metastases: evidence boundaries, tumor-microenvironment remodeling, and translational prospects.Frontiers in cell and developmental biology · 2026Review
- Immune architecture of colorectal cancer brain metastases: spatial TAM heterogeneity and PD-L1 dynamics.Frontiers in immunology · 2026Article
- Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients.Oncoimmunology · 2025Article
- Long-term clinical outcomes of bevacizumab for treatment of stereotactic radiosurgery-induced radiation necrosis in patients with brain metastases.Journal of neuro-oncology · 2025Article
- Evolving CAR T-Cell Therapy to Overcome the Barriers in Treating Pediatric Central Nervous System Tumors.Cancer discovery · 2025Review
- Stereotactic radiosurgery for patients with brain metastases: current principles, expanding indications and opportunities for multidisciplinary care.Nature reviews. Clinical oncology · 2025Review
- Review
- TIMP1 Mediates Astrocyte-Dependent Local Immunosuppression in Brain Metastasis Acting on Infiltrating CD8+ T Cells.Cancer discovery · 2025Article
- B cell immunity and therapeutic opportunities in brain metastases.Frontiers in immunology · 2025Review
- Treatment decisions for intermediate-sized brain metastases in or near the motor cortex among the neuro-oncology community.Brain & spine · 2025Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmune checkpoint inhibitors (ICI) have been a breakthrough for selected cancer patients, including those with brain metastases (BMs). Likewise, steroids have been an integral component of symptomatic management of BM patients. However, clinical evidence on the interaction between ICI and steroids in BM patients is conflicting and has not adequately been summarized thus far. Hence, the aim of this study was to perform a systematic literature review and meta-analysis on the association between steroid use and overall survival (OS) in BM patients receiving ICI.
methodsA systematic literature search was performed. Pooled effect estimates were calculated using random-effects models across included studies.
resultsAfter screening 1145 abstracts, 15 observational studies were included. Fourteen studies reported sufficient data for meta-analysis, comprising 1102 BM patients of which 32.1% received steroids. In the steroid group, median OS ranged from 2.9 to 10.2 months. In the nonsteroid group, median OS ranged from 4.9 to 25.1 months. Pooled results demonstrated significantly worse OS (HR = 1.84, 95% CI 1.22-2.77) and systemic progression-free survival (PFS; HR = 2.00, 95% CI 1.37-2.91) in the steroid group. Stratified analysis showed a consistent effect across the melanoma subgroup; not in the lung cancer subgroup. No significant association was shown between steroid use and intracranial PFS (HR = 1.31, 95% CI 0.42-4.07).
conclusionsAdministration of steroids was associated with significantly worse OS and PFS in BM patients receiving ICI. Further research on dose, timing, and duration of steroids is needed to elucidate the cause of this association and optimize outcomes in BM patients receiving ICI.
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Registered trials
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.