Liu XJ, Ge H, Yuan CL. Survival benefits of concurrent immune checkpoint inhibitor and radiotherapy in non-small cell lung cancer with brain metastases. World J Clin Oncol 2025; 16(8): 107009 [DOI: 10.5306/wjco.v16.i8.107009]
Corresponding Author of This Article
Chun-Luan Yuan, Department of Oncology, The First People’s Hospital of Lianyungang, No. 6 Zhenhua Road, Lianyungang 222016, Jiangsu Province, China. zhaoqin0909@sina.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Aug 24, 2025; 16(8): 107009 Published online Aug 24, 2025. doi: 10.5306/wjco.v16.i8.107009
Survival benefits of concurrent immune checkpoint inhibitor and radiotherapy in non-small cell lung cancer with brain metastases
Xue-Jie Liu, Heng Ge, Chun-Luan Yuan
Xue-Jie Liu, Chun-Luan Yuan, Department of Oncology, The First People’s Hospital of Lianyungang, Lianyungang 222016, Jiangsu Province, China
Heng Ge, Department of Oncology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, Henan Province, China
Co-corresponding authors: Heng Ge and Chun-Luan Yuan.
Author contributions: Liu XJ and Yuan CL participated in the conception and design of the study, wrote the manuscript, accessed and verified the study data; Liu XJ, Ge H, and Yuan CL were involved in the acquisition, analysis, and interpretation of data; Ge H and Yuan CL made equal contributions as co-corresponding authors. All authors critically reviewed and approved the final manuscript to be published.
Institutional review board statement: The present study was approved by the Research Ethics Committee of the First People’s Hospital of Lianyungang, No. 202308225.
Informed consent statement: Informed consent statement was finished prior to anticancer therapy.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Not applicable.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Luan Yuan, Department of Oncology, The First People’s Hospital of Lianyungang, No. 6 Zhenhua Road, Lianyungang 222016, Jiangsu Province, China. zhaoqin0909@sina.com
Received: March 14, 2025 Revised: May 7, 2025 Accepted: June 26, 2025 Published online: August 24, 2025 Processing time: 159 Days and 20.9 Hours
Abstract
BACKGROUND
The optimal sequencing of immune checkpoint inhibitor (ICI) and brain radiotherapy in the management of brain metastasis from non-small cell lung cancer (NSCLC) is unclear.
AIM
To evaluate the survival of concurrent ICI and consolidation ICI in NSCLC patients treated with brain radiotherapy.
METHODS
We retrospectively analyzed NSCLC patients treated with brain radiotherapy and ICI. Treatment response and survival were estimated. The cox proportional hazards regression model was utilized to investigate the association between overall survival and clinical variables.
RESULTS
There were 54 patients in concurrent ICI and radiotherapy group, and 62 individuals treated with radiotherapy followed by consolidation ICI. The objective response rates were similar between the two group. The median progression free survival was significantly high in the concurrent ICI group compared with consolidation ICI group (9.56 months vs 8.15 months, P = 0.038). In addition, the median overall survival was 22.08 months in the concurrent ICI group, clearly longer than that in the consolidation group (13.24 months, P = 0.009).
CONCLUSION
In NSCLC patients with brain metastases, our analyses suggested that radiotherapy concurrent with ICI was associated with significant benefit compared with radiotherapy followed by consolidation ICI.
Core Tip: Immunotherapy can combine with radiotherapy to destroy cancer, either use radiotherapy and immunotherapy at the same time, or treated with radiotherapy first and then use immunotherapy. However, what is the better sequence of radiotherapy and immunotherapy for non-small cell lung cancer patients with brain metastasis? In the present study, we collected the data of non-small cell lung cancer patients with brain metastasis, we found some patients received radiotherapy at first, and then treated with immunotherapy. Those patients did not live as long as patients treated with radiotherapy and immunotherapy at the same time.
