Department of Thoracic Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
The Centre of Molecular Diagnosis, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Cancer Res Clin Oncol. 2024 May 23;150(5):271. doi: 10.1007/s00432-024-05808-0.
Previous research has shown that both temozolomide (TMZ) and PD-1/L1 inhibitors (PD-1/L1) alone exhibit certain potential in the treatment of non-small cell lung cancer (NSCLC) with brain metastases (BM), in this study, we will explore combining the two in order to seek new effective treatment options for NSCLC with BM.
During 2021.1 to 2023.12, we collected the date of these pretreated-NSCLC with BM who accept the treatment of TMZ and PD-1/L1, the objective response ratio (ORR), progression-free survival (PFS) and overall survival (OS) were set as the primary endpoint, meanwhile, the toxicity of such regimen was also recorded.
About 42 patients are enrolled, our primary analysis demonstrated that the ORR of such regimen toward NSCLC with BM was 26.19%, with Approximate intracranial and extracranial lesion ORR was 6% and 20% respectively, the DCR was about 64.29%, the mean PFS and OS was about 4 m and 8.5 m. Further analysis indicated that the efficiency correlated with the diagnosis-Specific Graded Prognostic Assessment (ds-GPA) score. Moreover, the toxicity can also be tolerated, indicating the application potential of such regimen against NSCLC with BM.
Our results exhibited that with tolerated toxicity, the combination of TMZ and PD-1/L1 shows promising efficiency against NSCLC with BM, this would be of great significance for the treatment of NSCLC with brain metastasis. However, due to the limitation of sample and retrospective property, the real value of such regimen needed to be further confirmed in the future.
既往研究表明，替莫唑胺（TMZ）和 PD-1/L1 抑制剂（PD-1/L1）单药在治疗伴脑转移（BM）的非小细胞肺癌（NSCLC）方面均具有一定的潜力，本研究旨在探讨联合应用这两种药物，以期为伴 BM 的 NSCLC 寻求新的有效治疗选择。
2021 年 1 月至 2023 年 12 月，我们收集了接受 TMZ 和 PD-1/L1 治疗的预处理伴 BM 的 NSCLC 患者的资料，将客观缓解率（ORR）、无进展生存期（PFS）和总生存期（OS）作为主要终点，同时记录该方案的毒性。
共纳入 42 例患者，我们的初步分析表明，该方案治疗伴 BM 的 NSCLC 的 ORR 为 26.19%，颅内和颅外病变的 ORR 分别约为 6%和 20%，疾病控制率（DCR）约为 64.29%，中位 PFS 和 OS 分别约为 4 个月和 8.5 个月。进一步分析表明，该方案的疗效与诊断特异性分级预后评估（ds-GPA）评分相关。此外，该方案的毒性也可耐受，表明该方案对伴 BM 的 NSCLC 具有潜在应用价值。
我们的研究结果表明，TMZ 联合 PD-1/L1 具有较好的疗效，且毒性可耐受，为治疗伴脑转移的 NSCLC 提供了新的治疗选择。但由于样本量和回顾性研究的限制，该方案的实际价值还需要在未来进一步验证。
