SynthesisClinical & experimental metastasis2026
PD-1/ PD-l1 Inhibitors and Stereotactic Radiosurgery for Brain Metastases: a systematic review and meta-analysis.
Synthesis in Clinical & experimental metastasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeStereotactic radiosurgery (SRS) is the treatment of choice for limited brain metastases (BM), and its combination with PD-1/PD-L1 inhibitors is hypothesized to offer synergistic therapeutic benefits. However, there are concerns regarding augmented risk of radiation-induced brain necrosis (RIBN). This systematic review and meta-analysis evaluate the efficacy and toxicity profile of PD-1/PD-L1 inhibitors combined with SRS or fractionated stereotactic radiotherapy (FSRT).
methodsFour databases were screened, Embase, Web of Science, PubMed and Scopus from inception to November 2025. Primary outcomes were overall survival (OS), extracranial and distant intracranial progression free survival (PFS), and local control (LC). A subgroup analysis was performed based on the primary metastasis origin and radiotherapy treatment modalities. We extracted RIBN events and grade ≥ 3 neurological events. A single-arm meta-analysis was performed using the random-effects modeling. This review protocol was registered on November 2025 on PROSPERO (ID CRD420251171879).
resultsThirty-four studies were included, published between 2016 and 2025 comprising 2,587 patients with BM. The pooled one-year OS was 65% (95% CI 60-69). Patients with BM from Non-Small Cell Lung Cancer (NSCLC) had one-year OS (68%) while melanoma BM had OS (61%). LC and distant intracranial PFS at one year were 87% (95% CI 79-92) and 40.23% (95% CI 17.99-62.47), respectively. The cumulative incidence (CI) of grade 3 RIBN was 5% (95% CI 3-8), and grade ≥ 3 neurological events occurred in 7% (95% CI 4-13). No statistically significant difference in RIBN rates was found between melanoma and NSCLC primaries subgroup.
conclusionThe combination of SRS/FSRT with PD-1/PD-L1 inhibitors is associated with favorable intracranial PFS and LC and a tolerable toxicity profile, with relatively lower rates of grade 3 RIBN. These findings support the feasibility of this combined modality in the immunotherapy era. However, definitive conclusions regarding the incremental risk of RIBN require future prospective trials.
Indexed as
Identifiers
42891757What OpenQuestion holds
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.