Evidence map›Paper›PMID 39627765›Full record

ArticleBMC cancer2024

Efficacy and safety of combining anti-angiogenic therapy, radiotherapy, and PD-1 inhibitors in patients with driver gene-negative non-small cell lung cancer brain metastases: a retrospective study.

Xianwen Zhang, Qian Sun, Rujun Chen, MengDie Zhao, Feng Cai, Zhen Cui, Hao Jiang

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Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Xianwen ZhangDepartment of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Qian SunDepartment of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Rujun ChenDepartment of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
MengDie ZhaoDepartment of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Feng CaiDepartment of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Zhen CuiDepartment of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China.
Hao JiangDepartment of Radiation Oncology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China. jianghao1223@163.com.

Funding

Anhui Provincial Clinical Medical Research Transformation Project 202304295107020078Natural Science Research Project of Bengbu Medical College 2021byzd159
6 · The paper itself

Abstract

backgroundThe efficacy and safety of anti-angiogenic combination therapy in patients with driver gene-negative non-small cell lung cancer (NSCLC) with brain metastases (BM) are uncertain.

methodsEighty-eight records of driver gene-negative patients with NSCLC treated with craniocerebral radiotherapy (RT) and programmed death factor-1 (PD-1) inhibitors between May 2021 and May 2023 were collected. Based on whether anti-angiogenic therapy (AT) is combined or not, patients are categorized into the AT group and the non anti-angiogenic therapy (NAT) group. The NAT group patients received craniocerebral RT and PD-1 inhibitor and those in the AT group received craniocerebral RT and PD-1 inhibitor with ≥ 4 cycles of AT. Comparing the clinical efficacy and safety in these two patient cohorts was the main goal of the study.

resultsBy May 1, 2024, the iORR was 94.0% and 63.2% for AT and NAT group, respectively. The 1- and 2-year iLPFS for AT and NAT group were 93.6%, 80.9% and 69.7%, 36.4%, respectively. The 1- and 2-year iDPFS were 86.7%, 56.3% and 59.1%, 48.3%, respectively. The 1- and 2-year OS were 82.0%, 36.6% and 68.4%, 34.6%, respectively. Compared to the standard treatment (RT and PD-1 inhibitors), the addition of AT prolonged the median iLPFS (NR vs. 22.0 months, hazard ratio [HR] = 11.004, P < 0.001) and the median iDPFS (NR vs. 20.0 months, HR = 8.732, P = 0.003), but was not significant in the extension of the OS (21.0 vs. 19.0 months, HR = 1.601, P = 0.206). Multivariable analysis showed that combination therapy with AT is significantly associated with prolonged iLPFS (HR = 4.233, P = 0.002) and iDPFS (HR = 2.824, P = 0.007), whereas only GPA score is significantly associated with improved OS (HR = 0.589, P = 0.019). The incidence of hypertension in the AT group showed an increasing trend, and no significant increased risk of radiation-induced brain necrosis was found. No drug-related intracranial hemorrhage events occurred.

conclusionCombining AT, RT, and PD-1 inhibitors can substantially improve iLPFS and iDPFS for patients with driver gene-negative NSCLC with BM; however, it is not significantly associated with better OS.

Indexed as

Angiogenesis InhibitorsBrain NeoplasmsCarcinoma, Non-Small-Cell LungImmune Checkpoint InhibitorsLung NeoplasmsAdultAgedAged, 80 and overChemoradiotherapyFemaleHumansMaleMiddle AgedProgrammed Cell Death 1 ReceptorRetrospective StudiesTreatment OutcomeAngiogenesis InhibitorsImmune Checkpoint InhibitorsPDCD1 protein, humanProgrammed Cell Death 1 ReceptorAnti-angiogenic therapyBrain metastasesNon-small cell lung cancerProgrammed death factor-1 inhibitorsRadiotherapy

Identifiers

PMID39627765
PMCPMC11616174

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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.