TY - JOUR
T1 - Combination of radiotherapy and immunotherapy for brain metastases
T2 - A systematic review and meta-analysis
AU - Petrelli, Fausto
AU - De Stefani, Agostina
AU - Trevisan, Francesca
AU - Parati, Chiara
AU - Inno, Alessandro
AU - Merelli, Barbara
AU - Ghidini, Michele
AU - Bruschieri, Lorenza
AU - Vitali, Elisabetta
AU - Cabiddu, Mary
AU - Borgonovo, Karen
AU - Ghilardi, Mara
AU - Barni, Sandro
AU - Ghidini, Antonio
PY - 2019/12
Y1 - 2019/12
N2 - Radiotherapy (RT) represents a mainstay in the treatment of brain metastases (BMs) from solid tumors. Immunotherapy (IT) has improved survival of metastatic cancer patients across many tumor types. The combination of RT and IT for the treatment of BMs has a strong rationale, but data on efficacy and safety of this combination is still limited. A systematic search of PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE was conducted. 33 studies were included for a total of 1520 patients, most of them with melanoma (87%). Median pooled OS was 15.9 months (95%CI 13.9–18.1). One- and 2-year OS rates were 55.2% (95% CI 49.3–60.9) and 35.7% (95% CI 30.4–41.3), respectively. Addition of IT to RT was associated with improved OS (HR = 0.54, 95%CI 0.44-0.67; P < 0.001). For patients with BMs from solid tumors, addition of concurrent IT to brain RT is able to increase survival and provide long term control.
AB - Radiotherapy (RT) represents a mainstay in the treatment of brain metastases (BMs) from solid tumors. Immunotherapy (IT) has improved survival of metastatic cancer patients across many tumor types. The combination of RT and IT for the treatment of BMs has a strong rationale, but data on efficacy and safety of this combination is still limited. A systematic search of PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE was conducted. 33 studies were included for a total of 1520 patients, most of them with melanoma (87%). Median pooled OS was 15.9 months (95%CI 13.9–18.1). One- and 2-year OS rates were 55.2% (95% CI 49.3–60.9) and 35.7% (95% CI 30.4–41.3), respectively. Addition of IT to RT was associated with improved OS (HR = 0.54, 95%CI 0.44-0.67; P < 0.001). For patients with BMs from solid tumors, addition of concurrent IT to brain RT is able to increase survival and provide long term control.
KW - Brain metastases
KW - Immunotherapy
KW - Meta-analysis
KW - Radiotherapy
KW - Survival
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U2 - 10.1016/j.critrevonc.2019.102830
DO - 10.1016/j.critrevonc.2019.102830
M3 - Review article
AN - SCOPUS:85074787165
VL - 144
JO - Critical Reviews in Oncology/Hematology
JF - Critical Reviews in Oncology/Hematology
SN - 1040-8428
M1 - 102830
ER -