Dados do Trabalho

Título

THREE CASES SERIES OF NON-SMALL CELL LUNG CANCER WITH BRAIN METASTASIS TREATED WITH IMMUNOTHERAPY: IMPRESSIVE PROLONGED RESPONSE TIME

Introdução

Brain metastases are a common metastasis in lung cancer patients. Immunotherapy had a huge impact on the survival of a portion of patients. However, long-term outcomes in patients with brain metastases are still poorly known.

Objetivo

To demonstrate the long-term benefit of the duration of response with immunotherapy, monotherapy, in brain metastatic non-small cell lung cancer.

Método

Three patients with metastatic non-small cell lung cancer to the brain treated with immunotherapy at Hospital Alemão Oswaldo Cruz in São Paulo/SP, from March 2017 to September 2020, were reported. Two patients used it in the second line and one patient used it in the first line.

Resultado

Age ranged from 55 to 87 years, Two patients were female and one patient was male. Patient 1: Adenocarcinoma with PDL1 of 0%, used second-line Nivolumab, from March 2017 to March 2019, with a response duration of 40 months, in which he died. Patient 2: Adenocarcinoma with 20% PDL1, used second-line pembrolizumab from January 2018 to January 2020, maintaining a response duration of 41 months. Patient 3: Epidermoid carcinoma with PDL1 of 60%, used pembrolizumab in the first line, from August 2018 to September 2020, maintaining a response duration of 32 months. Patient 1 underwent radiosurgery and later total brain radiotherapy. Patients 2 and 3 had radiosurgery.

Conclusão

Despite the use of radiotherapy in the 3 cases, brain control was high compared to series before the advent of immunotherapy. Biological rationale for inducing an immune-mediated response from the use of radiotherapy is described in the literature. Larger prospective studies including patients with brain metastases at diagnosis are needed to assess the real role of combined or even exclusive treatment of immunotherapy in this scenario.

Palavras-chave

Brain metastases / Immunotherapy / The duration of response