Evaluating the effectiveness of immunotherapy in advanced lung cancer with and without brain metastases.

This study evaluated the effectiveness of immunotherapy in advanced lung cancer (LC) patients with and without brain metastases (BMs). The data showed that immunotherapy significantly improved overall survival in LC patients with and without BMs.

In 20-40% of patients with advanced LC, the cancer spreads from the lung to the brain (brain metastases, BM). This can lead to a decreased quality of life and reduced survival. The standard systemic (whole-body) treatment options like chemotherapy are not always effective for advanced LC with BM. Thus, new effective therapies to improve the outcomes of patients with advanced LC and BMs are required.

Immunotherapy has been found to be effective in advanced LC. Immune checkpoint inhibitors (ICIs) are a type of immunotherapy used to treat a wide variety of cancers. Pembrolizumab (Keytruda) and nivolumab (Opdivo) are ICIs that prevent the immune system from switching off. This allows the immune system to target and kill cancer cells. However, there are few studies evaluating the effectiveness of immunotherapy versus chemotherapy in patients with advanced LC with and without BMs.

This study analyzed 9 studies and involved 6241 patients with advanced LC. The patients were divided into 2 groups. Group 1 included 682 patients with BM. Group 2 included 5559 patients without BM.

In both groups 1 and 2, immunotherapy was associated with a 25% higher chance of survival compared to those who received chemotherapy.

Immunotherapy was 1.37 times more effective for patients in group 2 than for patients in group 1.

For patients with non-small cell lung cancer (NSCLC), immunotherapy was 1.04 times more effective for patients with BM. For patients with small cell lung cancer, immunotherapy was 1.54 times more effective for patients without BM.

This study concluded that immunotherapy significantly improved overall survival in patients with LC with and without BMs.

The number of patients included with BMs was very low in this study. This study did not evaluate patients with symptoms and/or untreated BM.