Evidence map›Paper›PMID 38963658›Full record

ArticleJournal of neuro-oncology2024

Patterns of brain metastases response to immunotherapy with pembrolizumab.

Amit Mahajan, Sarah L Goldberg, Sarah A Weiss, Thuy Tran, Kanwar Singh, Kavita Joshi, Mariam S Aboian, Harriet M Kluger, Veronica L Chiang

Abstract read
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In one paragraph

Article in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Immunotherapy in central nervous system tumors.International journal of surgery (London, England) · 2025
    Review
  3. Review
  4. 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

9 authors.

Amit MahajanDepartment of Radiology and Biomedical Imaging, Yale University School of Medicine, Neuroradiology Section, CB 30, 333, Cedar St, New Haven, CT, 06510, USA. amit.mahajan@yale.edu.
Sarah L GoldbergDepartment of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, USA.
Sarah A WeissDepartment of Medical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Thuy TranDepartment of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, USA.
Kanwar SinghDepartment of Radiology and Biomedical Imaging, Yale University School of Medicine, Neuroradiology Section, CB 30, 333, Cedar St, New Haven, CT, 06510, USA.
Kavita JoshiDepartment of Radiology and Biomedical Imaging, Yale University School of Medicine, Neuroradiology Section, CB 30, 333, Cedar St, New Haven, CT, 06510, USA.
Mariam S AboianDepartment of Radiology, Children's Hospital of Philadelphia , Philadelphia, PA, USA.
Harriet M KlugerDepartment of Medicine (Medical Oncology), Yale University School of Medicine, New Haven, CT, USA.
Veronica L ChiangDepartment of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCentral nervous system (CNS) metastases from lung cancers and melanoma, significantly contribute to morbidity and mortality. Despite advances in local therapies, there is a need for effective systemic treatments. Pembrolizumab, a PD-1 inhibitor, has shown promise for some patients with untreated brain metastases from melanoma and non-small cell lung cancer (NSCLC). This study aims to analyze the response of brain metastasis to pembrolizumab and associate characteristics like size and location with treatment outcome.

methodsThis retrospective study used imaging data from a phase II trial of pembrolizumab in melanoma or NSCLC patients with untreated brain metastases. MRI evaluations were conducted at 2 month intervals, with each brain metastasis treated as a distinct tumor for response assessment, based on modified RECIST criteria (maximum 5 lesions, 5 mm target lesions).

resultsOf 130 individual target metastases (> 5 mm), in 65 patients with NSCLC (90 metastases) and Melanoma (40 metastases), 32 (24.6%) demonstrated complete resolution, 24 (18.5%) had partial resolution, 32 (24.6%) were SD and 42 (32.3%) demonstrated PD. Those smaller than 10 mm were more likely to show complete resolution (p = 0.0218), while those ≥ 10 mm were more likely to have PR. There was no significant association between size, number or location (supratentorial vs. infratentorial) and lesion progression. The median time to metastatic lesion progression in the brain was 5.7-7 weeks.

conclusionPembrolizumab is effective in brain metastases from NSCLC and melanoma, showing response (CR + PR) in 43% and progression (PD) in 32% of metastases. With the median time to CNS progression of 5.7-7 weeks, careful radiographic monitoring is essential to guide timely local treatment decisions.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalBrain NeoplasmsCarcinoma, Non-Small-Cell LungLung NeoplasmsMelanomaAdultAgedAged, 80 and overClinical Trials, Phase II as TopicFemaleFollow-Up StudiesHumansImmunotherapyMaleMiddle AgedAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalpembrolizumabCNS metastasesImmune therapyPembrolizumab

Identifiers

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Registered trials

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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.