Department of Respiratory Medicine, Peking Union Medical College, Beijing, China.
Thorac Cancer. 2019 Feb;10(2):381-385. doi: 10.1111/1759-7714.12963. Epub 2019 Jan 7.
Non-small cell lung cancer (NSCLC) accounts for up to 85% of all lung cancers. Central nervous system metastases are a common complication of NSCLC and confer a poor prognosis and a dismal survival rate. Treatment is limited, has poor outcomes, and affects patient quality of life. Pembrolizumab is an anti-PD-1 antibody that has shown good results for the management of NSCLC. However, its penetration of the central nervous system has not been well studied, and patients with untreated brain metastases are excluded from most clinical trials. Herein, we report two cases of NSCLC with brain metastases in patients successfully treated with pembrolizumab, and discuss the efficacy and safety of pembrolizumab in these patients. Pembrolizumab has shown good control and the patients have had long progression-free survival with a high quality of life. Neither patient has experienced serious or grade 3-4 treatment-related adverse events. Pembrolizumab demonstrates activity in brain metastases in NSCLC patients with an acceptable safety profile. Thus, there may be a role for systemic immunotherapy in patients with untreated or progressive brain metastases.
非小细胞肺癌（NSCLC）约占所有肺癌的 85%。中枢神经系统转移是 NSCLC 的常见并发症，预后不良，生存率低。治疗方法有限，效果不佳，且影响患者的生活质量。Pembrolizumab 是一种抗 PD-1 抗体，在 NSCLC 的治疗中显示出良好的效果。然而，其对中枢神经系统的穿透性尚未得到很好的研究，大多数临床试验都排除了未经治疗的脑转移患者。在此，我们报告了两例 NSCLC 伴脑转移患者，他们接受 pembrolizumab 治疗取得了成功，并讨论了 pembrolizumab 在这些患者中的疗效和安全性。Pembrolizumab 显示出良好的控制效果，患者无进展生存期长，生活质量高。两名患者均未出现严重或 3-4 级治疗相关不良事件。Pembrolizumab 在 NSCLC 伴脑转移患者中具有活性，且安全性可接受。因此，对于未经治疗或进展性脑转移的患者，全身免疫治疗可能具有一定作用。
