Retrospective real-world data of immunotherapy benefits for large brain metastases from non-small cell lung cancer

Non-small cell lung cancer (NSCLC) patients with large brain metastases (BrM), defined as ≥ 2 cm in diameter historically face grim prognoses. Immunotherapy is emerging as a promising avenue for BrM management. A retrospective real-world study in the MedStar Georgetown Cancer Network (Washington, DC) included 36 patients with large BrM from NSCLC, who had undergone neurosurgery and/or radiation, and subsequently received immunotherapy (33 pembrolizumab, 2 atezolizumab, 1 durvalumab). The median follow-up was 17.6 months. The median intracranial progression-free survival and overall survival were 9.2 months and 31 months, respectively. The intracranial PFS HR was 0.07 (95% CI 0.02-0.26) for patients who received at least 90 days of immunotherapy compared to those who did not. Each additional 30 days of immunotherapy was associated with an OS HR 0.77 (95% CI 0.67-0.90). The authors conclude that this real-world data highlight the potential of immunotherapy in large BrM NSCLC patients, a population often excluded from clinical trials.