EckMate-012 study, the cohort integrated 12 newly treated sufferers with asymptomatic NSCLC with BMs. After therapy with nivolumab alone, the ORR was 16.7 , the DCR was 16.7 , the median OS was 8.0 months, and also the median PFS was 1.6 months [135]. A retrospective study from the nivolumab expanded access system integrated individuals with Stearoyl-L-carnitine Autophagy advanced lung squamous cell carcinoma (n = 371) and non-squamous NSCLC (n = 1588). The Ganoderic acid DM Inhibitor outcomes showed that nivolumab has equivalent benefits in advanced lung squamous cell carcinoma and non-squamous cell NSCLC, using a total DCR of 49 and 40 and CNS ORR of 19 and 17 , respectively [136]. The OAK study results showed that compared with docetaxel, atezolizumab remedy of NSCLC BMs led to much better median OS (16.0 months vs. 11.9 months, HR = 0.74, p = 0.1633) and fewer reports of treatment-related AEs, severe AEs, and treatment-related neurological AEs. Atezolizumab also had demonstrated preventive effects against new BMs (median time for you to new brain metastases: 9.five months, HR = 0.38, p = 0.0239) [137]. Inside the phase II clinical FIR study, the ORR of 13 asymptomatic patients with NSCLC BMs treated with atezolizumab was 23 , and also the median OS and median PFS were six.8 months and 4.three months, respectively [120]. Monotherapy can directly determine the efficacy of a drug. These compact sample sizes and potential research recommend that the short-term efficacy of ICIs inside the remedy of intracranial lesions in individuals with NSCLC BM is comparable to that of extracranial lesions; nonetheless, the PFS and OS are shorter, which may be because of the little sample bias. Moreover, sufferers with symptomatic BMs are generally excluded from clinical research. TheCells 2021, 10,9 ofefficacy of ICI monotherapy for NSCLC BMs needs to be further confirmed in large-sample potential research. five.two. Therapy Progress of ICI Monotherapy Combined with Chemotherapy/Radiotherapy for NSCLC CNS Metastasis A retrospective study showed that pembrolizumab plus chemotherapy compared with chemotherapy alone can enhance the ORR of sufferers with BMs (80 vs. 58.3 , p = 0.75) and minimize the progression price of BMs (33.three vs. 91.7 , p = 0.009) [138]. The KEYNOTE189 study, which included 108 sufferers with EGFR/ALK-negative non-squamous NSCLC BMs, reported that pembrolizumab combined with platinum and pemetrexed significantly improved the OS compared with chemotherapy alone (19.two months vs. 7.5 months) [139]. The 2019 ASCO meeting retrospectively analyzed the information of 13,998 individuals with NSCLC in the National Cancer Database, and it showed that patients with NSCLC BMs treated with immunotherapy plus intracranial radiotherapy had a longer median OS than individuals treated with intracranial radiotherapy alone (13.1 months vs. 9.7 months) [140]. The outcomes on the retrospective evaluation of your American Hopkins Hospital on SRS/SRT therapy of tumor sufferers with BMs also suggested that immunotherapy combined with simultaneous SRS/SRT can improve OS and reduce the incidence of new BMs [141]. The time window for radiotherapy combined with immunotherapy is worth exploring. A retrospective study by the Moffitt Cancer Center in the United states of america showed that immunotherapy combined with radiotherapy, in particular receiving SRS before or simultaneously with immunotherapy, can significantly increase the intracranial manage rate compared with radiotherapy alone (57 vs. 0 ) [142]. In terms of security, a retrospective study of 54 patients with NSCLC BMs showed that there was no signific.
