Multicenter phase 2 trial of first-line brain radiotherapy plus camrelizumab and chemotherapy for NSCLC with brain metastases

The phase 2 C-Brain trial, at nine centers in China, evaluated brain radiotherapy (WBT or SRS) in combination with camrelizumab and platinum-doublet chemotherapy in patients with newly diagnosed advanced NSCLC with no actionable driver mutations (EGFR, ALK, or ROS1) and brain metastases. The 6- month progression-free survival rate was 71.7% (95% CI 58.9-81.8%) during the median follow-up of 14.1 months (IQR 9.0-20.3). The most common grade 3 or 4 treatment-related adverse events were decreased neutrophil count (22% of patients), decreased white blood cell count (15%), decreased platelet count (15%), and decreased lymphocyte count (14%). Grade 3 neurological toxic effects occurred in 5%, and grade 1 or 2 radiation necrosis in 5%. There were no grade 5 TRAEs. The authors conclude that brain radiotherapy in combination with camrelizumab and platinum-doublet chemotherapy showed promising efficacy and manageable toxicity for previously untreated NSCLC with brain metastases.