ArticleThoracic cancer2025
First-Line Immune-Combination Therapy for Driver Gene-Negative NSCLC With Brain Metastases: Real-World Outcomes.
Article in Thoracic cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Construction of a survival prediction model and analysis of influencing factors for brain metastasis in non-small cell lung cancer based on multi‑parameter clinical data.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
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8 authors.
Funding
Abstract
backgroundOptimal treatment for driver gene-negative non-small cell lung cancer (NSCLC) with brain metastases (BM) remains unclear, particularly regarding immune checkpoint inhibitor (ICI)-based combinations and local BM therapy. Predictive biomarkers for intracranial efficacy are also undefined.
methodsThis retrospective study analyzed driver gene-negative NSCLC patients with BM treated with first-line ICI-based systemic therapy (ICI plus chemotherapy [ICI + CT] or ICI + CT plus bevacizumab [ICI + CT + Bev]) from June 2019 to June 2024. The intracranial progression-free survival (icPFS), progression-free survival (PFS), and overall survival (OS) were compared between treatment groups and by BM local therapy. The PD-L1 tumor proportion score (TPS) expression was evaluated for correlation with intracranial efficacy.
resultsA total of 36 patients were enrolled in the study. The intracranial objective response rate (icORR) was 70.6% (ICI + CT) versus 78.6% (ICI + CT + Bev) (p = 0.689), with no significant differences in icPFS, PFS, or OS between the two different first-line systemic regimens (all p > 0.05). Local BM therapy (n = 18) did not improve icPFS and OS (all p > 0.05). Extracranial PD-L1 (TPS ≥ 50%, n = 13) correlated with superior icPFS, PFS, and OS (all p < 0.05) versus PD-L1 TPS < 50%. Multivariate analysis confirmed PD-L1 ≥ 50% as an independent prognostic factor (HR = 0.155; 95% CI, 0.025-0.939; p = 0.042).
conclusionsAdding bevacizumab to first-line ICI-chemotherapy did not enhance survival outcomes. Local treatment for BM did not provide additional survival advantages when combined with first-line ICI-based systemic therapy. Extracranial PD-L1 TPS ≥ 50% predicted improved intracranial efficacy.
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