Department of Medicine (DAME), University of Udine, 33100 Udine, Italy.
Department of Oncology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy.
Int J Mol Sci. 2022 Jun 25;23(13):7068. doi: 10.3390/ijms23137068.
Approximately 40% of unselected non-small cell lung cancer (NSCLC) patients develop brain metastases (BMs) during their disease, with considerable morbidity and mortality. The management of BMs in patients with NSCLC is a clinical challenge and requires a multidisciplinary approach to gain effective intracranial disease control. Over the last decade, immune checkpoint inhibitors (ICIs) have emerged as a game-changer in the treatment landscape of advanced NSCLC, with significant improvements in survival outcomes, although patients with BMs are mostly underrepresented in randomized clinical trials. Moreover, the safety and activity of ICIs and radiotherapy combinations compared with single-agent or sequential modalities is still under evaluation to establish the optimal management of these patients. The aim of this review is to summarize the state-of-the-art of clinical evidence of ICIs intracranial activity and the main challenges of incorporating these agents in the treatment armamentarium of NSCLC patients with BMs.
约 40%未经选择的非小细胞肺癌（NSCLC）患者在疾病过程中会发生脑转移（BMs），这带来了相当大的发病率和死亡率。NSCLC 患者 BMs 的治疗是一个临床挑战，需要多学科方法来获得有效的颅内疾病控制。在过去十年中，免疫检查点抑制剂（ICIs）在晚期 NSCLC 的治疗领域中崭露头角，生存结果有了显著改善，尽管 BMs 患者在随机临床试验中大多代表性不足。此外，ICI 和放疗联合与单药或序贯治疗相比的安全性和活性仍在评估中，以确定这些患者的最佳治疗方法。本综述的目的是总结 ICI 颅内活性的临床证据现状，以及将这些药物纳入 NSCLC 伴 BMs 患者治疗方案的主要挑战。
