Objective:

To evaluate the efficacy and safety of WBRT plus immunotherapy versus SRT plus immunotherapy in patients with driver-gene-negative NSCLC and brain metastases.

Approach:

Key Findings:

• SRT+I demonstrated superior median overall survival (29.3 months) compared to WBRT+I (19.9 months, P = 0.034).
• SRT+I also showed better intracranial progression-free survival (14.7 months vs. 9.4 months, P = 0.038).
• Higher intracranial objective response rate for SRT+I (78.6%) compared to WBRT+I (61.5%).
• SRT+I had a lower incidence of radiation-induced brain injury (3.75% vs. 10.26%) and no grade ≥3 immune-related adverse events.

Interpretation:

SRT combined with immunotherapy offers better survival and disease control outcomes for patients with driver-gene-negative NSCLC and brain metastases compared to WBRT combined with immunotherapy.

Limitations:

• The study is retrospective and conducted at a single center, which may limit generalizability.
• Potential selection bias despite IPTW adjustment.

Conclusion:

SRT+I is associated with superior outcomes in driver-gene-negative NSCLC patients with brain metastases, particularly in those with limited brain metastases.

Attribution Notice

This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.