In a nutshell
The study evaluated the timing of radiotherapy (RT) and immune-checkpoint therapy (ICT) on the outcomes of patients with brain metastasis (BrM) resulting from melanoma and non-small cell lung cancer (NSCLC). The authors found that RT and ICT given at the same time may improve response and delay recurrence in these patients.
ICT is a type of immunotherapy that blocks proteins called immune checkpoints. Immune checkpoints normally prevent immune responses to be so strong that they attack healthy cells. However, many cancers such as melanoma or NSCLC develop such proteins that prevent the immune system to detect and kill cancer cells. Therefore, they can easily spread to other organs such as the brain (BrM). ICT detects such proteins and have improved the outcomes of patients with cancer.
RT has traditionally been used to treat BrMs. However, a number of patients still have recurrences and side effects. Preliminary data suggested safety and antitumor-activity of combining RT and ICT in patients with BrM. However, the optimal timing of this combination in patients with melanoma and NSCLC is unknown.
Methods & findings
The study analyzed the records of 110 patients with BrMs resulting from melanoma and NSCLC. Group 1 received ICT and RT concurrently (RT on the same day or between doses of an ICT course). Group 2 received RT within 90 days of ICT.
Group 1 had a significantly higher tumor response (70%) compared to group 2 (47%). Response to treatment occurred significantly faster in group 1 (by 76%) compared to group 2. Group 1 also had a significantly lower occurrence of disease progression (5%) compared to group 1 (26%). Patients in group 1 had a 58% lower risk of developing a local recurrence compared to those in group 2.
The bottom line
The study concluded that RT plus ICT given at the same time may improve tumor response and delay recurrence in patients with BrM from melanoma and NSCLC.
The fine print
The study looked back in time to analyze data from one US hospital only. The number of patients was relatively low. Further studies are needed.
Published By :
Sep 14, 2020