ArticleJournal of the National Comprehensive Cancer Network : JNCCN2021
Bone Metastases, Skeletal-Related Events, and Survival in Patients With Metastatic Non-Small Cell Lung Cancer Treated With Immune Checkpoint Inhibitors.
Article in Journal of the National Comprehensive Cancer Network : JNCCN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 4 of them syntheses that pooled it.
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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.
Who cites it
46 citing papers in PubMed, 4 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Radiotherapy plus immune checkpoint inhibitors versus immune checkpoint inhibitors alone for non-small cell lung cancer with bone metastases: a systematic review and meta-analysis of comparative cohort studies.Frontiers in immunology · 2026Pooled it
- Response rate specific to bone metastasis of various cancers for immune checkpoint inhibitors: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Pooled it
- Impact of bone metastasis on the prognosis of non-small cell lung cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024Pooled it
- Impact of bone metastasis on prognosis in non-small cell lung cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Value of CT Radiomics and Clinical Features in Predicting Bone Metastases in Patients with NSCLC.Contrast media & molecular imaging · 2022Trial
- Dissociated skeletal response to first-line immunotherapy in synchronous bone metastatic non-small cell lung cancer patients: Clinical profiles and survival benefit of denosumab adjunction.Journal of bone oncology · 2026Article
- Breaking the immune "cold niche" in bone metastasis: core mechanisms of the multidimensional interwoven regulatory network and precision breakthrough strategies.Molecular cancer · 2026Review
- Immune Checkpoint Inhibitors and Bone Health: Mechanisms, Clinical Implications, and Emerging Perspectives on Bone Fragility.Current osteoporosis reports · 2026Review
- The Neuro-Bone Axis in Metastatic Progression: Innervation, Neuro-Immune-Osteoclast Crosstalk, and Therapeutic Opportunities.Biology · 2026Review
- A pan-cancer single-cell transcriptomic atlas of human bone metastases.Cell reports. Medicine · 2026Article
- A novel multimodal model integrating CT-based deep learning and clinical information for predicting 1-year OS of first-line immunotherapy in ES-SCLC patients.Frontiers in oncology · 2026Article
- Immune checkpoint inhibition in bone metastases: lesion response heterogeneity, the osteoimmune niche, and microenvironment-directed therapy.Frontiers in immunology · 2026Review
- Nanomedicine-Based Strategies Targeting Macrophage Polarization in Breast Cancer Bone Metastasis: An Updated Review.Breast cancer (Dove Medical Press) · 2026Review
- Evaluating risk factors for skeletal-related events among bone metastases from solid tumors.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2025Article
- Immune checkpoint inhibitors combined with chemotherapy as first-line treatment may improve clinical outcomes in advanced non-small cell lung cancer with bone metastases.Translational lung cancer research · 2025Article
- Clinical Characteristics, Prognostic Factors and Therapeutic Strategies in Gastric Cancer Patients With Bone Metastasis: A Retrospective Analysis.Cancer medicine · 2025Article
- Efficacy of innovative systemic treatments in combination with radiotherapy for bone metastases: a GEMO (the European Study Group of Bone Metastases) state of the art.Cancer metastasis reviews · 2025Review
- Impact of Bone-Modifying Agents on Post-Bone Metastasis Survival Across Cancer Types.Current oncology (Toronto, Ont.) · 2025Article
- Clinical outcomes and safety of continuous immunotherapy beyond progression in patients with extensive-stage small cell lung cancer: a retrospective real-world study.Frontiers in immunology · 2025Article
- Efficacy of Immunotherapy in Patients With Bone Metastases From Driver Gene-Negative Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Clinical Medicine Insights. Oncology · 2025Article
Corrections and comments
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Authors and funding
25 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundBone metastases and skeletal-related events (SREs) are a frequent cause of morbidity in patients with metastatic non-small cell lung cancer (mNSCLC). Data are limited on bone metastases and SREs in patients with mNSCLC treated using immune checkpoint inhibitors (ICIs), and on the efficacy of bone-modifying agents (BMAs) in this setting. Here we report the incidence, impact on survival, risk factors for bone metastases and SREs, and impact of BMAs in patients with mNSCLC treated with ICIs in a multi-institutional cohort. PATIENTS AND
methodsWe conducted a retrospective study of patients with mNSCLC treated with ICIs at 2 tertiary care centers from 2014 through 2017. Overall survival (OS) was compared between patients with and without baseline bone metastases using a log-rank test. A Cox regression model was used to evaluate the association between OS and the presence of bone metastases at ICI initiation, controlling for other confounding factors.
resultsWe identified a cohort of 330 patients who had received ICIs for metastatic disease. Median patient age was 63 years, most patients were treated in the second line or beyond (n=259; 78%), and nivolumab was the most common ICI (n=211; 64%). Median OS was 10 months (95% CI, 8.4-12.0). In our cohort, 124 patients (38%) had baseline bone metastases, and 43 (13%) developed SREs during or after ICI treatment. Patients with bone metastases had a higher hazard of death after controlling for performance status, histology, line of therapy, and disease burden (hazard ratio, 1.57; 95% CI, 1.19-2.08; P=.001). Use of BMAs was not associated with OS or a decreased risk of SREs.
conclusionsPresence of bone metastases at baseline was associated with a worse prognosis for patients with mNSCLC treated with ICI after controlling for multiple clinical characteristics. Use of BMAs was not associated with reduced SREs or a difference in survival.
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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.