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Clinical efficacy of immune checkpoint inhibitors in patients with brain metastases
Vincenzo Di Nunno1, Giacomo Nuvola2, Mirta Mosca2
1Department of Medical Oncology, Azienda USL, Bologna, Italy.
Abstract:
Brain metastases (BMs) represent a negative prognostic factor for patients with solid malignancies. BMs are generally approached with loco-regional treatments and the blood-brain barrier limits the efficacy of some systemic drugs. The aim of this review is to summarize current knowledge about the role of immune checkpoint inhibitors for the management of brain metastases in patients with solid malignancies. We performed a review of available literature. Immune checkpoint inhibitors represent the standard treatment for several advanced solid malignancies. However, with the exception of melanoma their clinical role in other solid malignancies is not completely clear due to the exclusion of patients with BM from approval clinical trials. Immune-checkpoint inhibitors may be an effective treatment of brain metastases of melanoma while their clinical role on brain metastases from other solid malignancies is uncertain.
Insights
Immune checkpoint inhibitors show promise for brain metastases (BMs) management in melanoma patients. Their effectiveness for BMs in other solid tumors remains uncertain, requiring further research.
Area of Science:
- Oncology
- Immunology
- Neurology
Background:
- Brain metastases (BMs) are a significant negative prognostic factor in solid malignancies.
- The blood-brain barrier restricts systemic drug efficacy for BMs.
- Loco-regional treatments are standard for BMs, but systemic options are evolving.
Purpose of the Study:
- To review current knowledge on immune checkpoint inhibitors (ICIs) for managing BMs.
- To clarify the clinical role of ICIs in solid tumors with BMs.
Main Methods:
- Literature review of available studies on ICIs and BMs.
- Analysis of clinical trial data and outcomes.
Main Results:
- ICIs are standard for advanced solid malignancies but often exclude patients with BMs.
- ICIs demonstrate potential efficacy in melanoma BMs.
- Clinical data for ICIs in non-melanoma BMs are limited and uncertain.
Conclusions:
- ICIs may be effective for melanoma brain metastases.
- Further investigation is needed to establish the role of ICIs in BMs from other solid malignancies.
