This study states that The activity of immune checkpoint inhibitors (ICI) against NSCLC brain metastases is unknown.

We compared CNS outcomes between ICI- and chemo-treated patients who have received brain RT. ICI-treated patients were less likely to have CNS involvement at the time of systemic progression. Intracranial PFS was superior in patients treated with brain RT and ICI.Cumulative incidence of CNS progression was significantly less in patients with PD-L1 ≥ 50 %.

Immune checkpoint inhibitors (ICIs) have excellent systemic activity and are standard first line treatment in EGFR/ALK wild type metastatic non-small cell lung cancer (NSCLC). However, their role in patients with brain metastases, which affects over 20% of patients and cause significant morbidity, is less clear.

We reviewed patients with EGFR/ALK wild-type mNSCLC with CNS metastases. Serial MRIs were reviewed to determine the time to intracranial progression (iPFS). Multivariate regression was performed to adjust for the disease-specific graded prognostic score (ds-GPA). We identified 36 ICI- and 33 chemotherapy-treated patients with baseline CNS metastases and available serial MRIs (average frequency:3.5 months).

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