Navigate Towards the Immunotherapy Era: Value of Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer Patients With Brain Metastases

Brain metastases (BMs) in non-small-cell lung cancer (NSCLC) patients are associated with significant morbidity and poor prognosis. Immune checkpoint inhibitors (ICIs) have resulted in a paradigm shift in the management of advanced NSCLC. However, the value of ICIs in NSCLC patients with BMs remains unclear because patients with BMs are routinely excluded in numerous prospective trials on ICIs. Here, starting from the mechanisms of ICIs for BMs, we will reveal the value of ICIs by reviewing the efficacy and adverse effects of ICIs monotherapy as well as promising combination strategies, such as combinations with chemotherapy, radiotherapy, and anti-angiogenic drugs, etc. In addition, the methods of patient selection and response assessment will be summarized to assist clinical practice and further studies.

Automated summary

Brain metastases have a negative impact on the prognosis of NSCLC patients. Immune checkpoint inhibitors have been used for the treatment of advanced NSCLC, but their value in patients with brain metastases is unclear. This study reviews the efficacy and adverse effects of ICIs monotherapy, as well as promising combination strategies with chemotherapy, radiotherapy, and anti-angiogenic drugs, and summarizes the methods of patient selection and response assessment.