多中心分析免疫检查点抑制剂作为孤立性脑转移瘤治疗后的辅助治疗。
A Multicenter Analysis of Immune Checkpoint Inhibitors as Adjuvant Therapy Following Treatment of Isolated Brain Metastasis.
机构信息
School of Medicine, Vanderbilt University, Nashville, Tennessee, USA.
Université de Versailles-Saint-Quentin-en-Yvelines, Université Paris-Saclay, Biomarkers in Cancerology and Hemato-oncology, Department of General and Oncologic Dermatology, Ambroise-Paré Hospital, Assistance Publique - Hôpitaux de Paris, Boulogne-Billancourt, France.
出版信息
Oncologist. 2021 Mar;26(3):e505-e507. doi: 10.1002/onco.13608. Epub 2020 Dec 8.
BACKGROUND
The objective of this work was to characterize outcomes of patients with isolated brain metastases managed with local therapy followed by immune checkpoint inhibitor (ICI) therapy.
MATERIALS AND METHODS
Patients from four medical centers were included if they presented with isolated brain metastases treated with local therapy and received adjuvant treatment with ICIs.
RESULTS
Eleven patients with median size of largest brain metastasis of 3.9 cm, treated with surgical resection (n = 8) and/or stereotactic radiosurgery (SRS; n = 6), were included. Ipilimumab/nivolumab was the adjuvant ICI used in four patients, of whom one recurred (25%) and none died, compared with three of seven (43%) who recurred and two of seven (29%) who died following adjuvant treatment with ICI monotherapy. All recurrences were intracranial.
CONCLUSION
Patients with isolated brain metastases treated with surgery or SRS appeared to benefit from adjuvant ICI therapy, particularly with combination therapy. Recurrences in this setting appear to largely occur intracranially.
背景
本研究旨在描述接受局部治疗后序贯免疫检查点抑制剂（ICI）治疗的孤立性脑转移患者的结局特征。
材料与方法
纳入标准为存在孤立性脑转移且接受局部治疗，以及接受 ICI 辅助治疗的 4 家医疗中心的患者。
结果
共纳入 11 例患者，最大脑转移灶的中位数大小为 3.9cm，其中 8 例行手术切除术，6 例行立体定向放射外科手术（SRS）。4 例患者接受了辅助 ICI（ipilimumab/nivolumab）治疗，其中 1 例（25%）复发，无死亡病例；而 7 例接受 ICI 单药辅助治疗的患者中，3 例（43%）复发，2 例（29%）死亡。所有复发均为颅内复发。
结论
接受手术或 SRS 治疗的孤立性脑转移患者似乎从辅助 ICI 治疗中获益，特别是联合治疗。该治疗环境下的复发主要发生在颅内。
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