Background/Aim: Brain metastases are an additional challenge in patients with non-small-cell lung cancer (NSCLC) because most chemotherapy agents cannot cross the blood-brain barrier. Nivolumab has demonstrated efficacy in patients with advanced squamous NSCLC, but because patients with central nervous system (CNS) metastases are typically excluded from registration trials, 'field-practice' data are needed. Patients and Methods: Patients in the Italian cohort of the Expanded Access Program (EAP) who had CNS metastases at baseline were analyzed. Results: Thirty-seven patients with CNS metastases received a median of six doses of nivolumab. Three patients (8%) had grade 3-4 adverse events and one patient discontinued due to an adverse event. The objective response rate was 19%. Median overall survival was 5.8 (95% confidence interval=1.9-9.8) months and median progression-free survival was 4.9 (95% confidence interval=2.7-7.1) months. Conclusion: The safety and efficacy of nivolumab in patients with CNS metastases appear to be similar to those seen in the overall EAP cohort in Italy.

Italian Cohort of the Nivolumab EAP in Squamous NSCLC: Efficacy and Safety in Patients With CNS Metastases

Grossi, Francesco;
2019-01-01

Abstract

Background/Aim: Brain metastases are an additional challenge in patients with non-small-cell lung cancer (NSCLC) because most chemotherapy agents cannot cross the blood-brain barrier. Nivolumab has demonstrated efficacy in patients with advanced squamous NSCLC, but because patients with central nervous system (CNS) metastases are typically excluded from registration trials, 'field-practice' data are needed. Patients and Methods: Patients in the Italian cohort of the Expanded Access Program (EAP) who had CNS metastases at baseline were analyzed. Results: Thirty-seven patients with CNS metastases received a median of six doses of nivolumab. Three patients (8%) had grade 3-4 adverse events and one patient discontinued due to an adverse event. The objective response rate was 19%. Median overall survival was 5.8 (95% confidence interval=1.9-9.8) months and median progression-free survival was 4.9 (95% confidence interval=2.7-7.1) months. Conclusion: The safety and efficacy of nivolumab in patients with CNS metastases appear to be similar to those seen in the overall EAP cohort in Italy.
2019
2019
https://ar.iiarjournals.org/content/39/8/4265/tab-article-info
Brain metastases; PD1 inhibitor; immunotherapy; real-world evidence; Adult; Aged; Blood-Brain Barrier; Brain Neoplasms; Carcinoma, Non-Small-Cell Lung; Central Nervous System Neoplasms; Cohort Studies; Female; Humans; Italy; Male; Middle Aged; Neoplasm Staging; Nivolumab
Cortinovis, Diego; Chiari, Rita; Catino, Annamaria; Grossi, Francesco; DE Marinis, Filippo; Sperandi, Francesca; Piantedosi, Francovito; Vitali, Milena; Parra, Hector J Soto; Migliorino, Maria Rita; Tondini, Carlo; Tassinari, Davide; Frassoldati, Antonio; Verderame, Francesco; Pazzola, Antonio; Cognetti, Francesco; Palmiotti, Gennaro; Marchetti, Paolo; Santoro, Armando; Giannarelli, Diana; Colonese, Francesca; Delmonte, Angelo
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11383/2141993
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