The Role of Immune Checkpoint Inhibitors in Leptomeningeal Disease: A Systematic Review.
Anticancer Res
; 41(11): 5333-5342, 2021 Nov.
Article
em En
| MEDLINE
| ID: mdl-34732403
ABSTRACT
BACKGROUND/AIM:
Leptomeningeal disease (LMD) is a debilitating complication of advanced malignancies. Immune-checkpoint inhibitors (ICIs) may alter disease course. We analyzed the role and toxicity of ICIs in LMD. MATERIALS ANDMETHODS:
We systematically reviewed the literature reporting on outcome data of patients with LMD treated with ICIs.RESULTS:
We included 14 studies encompassing 61 patients. Lung-cancer (44.3%), breast-cancer (27.9%), and melanoma (23.0%) were the most frequent primary tumors. Median duration of ICI-treatment was 7-months (range=0.5-58.0) pembrolizumab (49.2%), nivolumab (32.8%), ipilimumab (18.0%). Radiological responses included complete response (33.3%), partial response (12.5%), stable disease (33.3%), progressive disease (20.8%). Twenty-two patients developed ICI-related adverse-events, mild (100%) and/or severe (15.6%). Median progression-free and overall survival were 5.1 and 6.3 months, and 12-month survival was 32.1%. Survival correlated with ICI agents (p=0.042), but not with primary tumors (p=0.144). Patients receiving concurrent steroids showed worse survival (p=0.040).CONCLUSION:
ICI therapy is well-tolerated in patients with LMD, but concurrent steroids may worsen survival.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
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Inibidores de Checkpoint Imunológico
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Neoplasias Meníngeas
Tipo de estudo:
Etiology_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article