Acute neurologic toxicity of palliative radiotherapy for brain metastases in patients receiving immune checkpoint blockade

Neuro-oncology Practice
W Tristram ArscottJoshua Jones

Abstract

The interaction between immune checkpoint blockade (ICB) and radiation (RT) for brain metastases has not been well understood. Given that acute neurotoxicity from this combination is not well characterized, we reviewed patients receiving ICB and RT for brain metastases. Patients treated with ICB and cranial RT from 2010 through 2017 were reviewed. ICB and RT must have been administered within 30 days of each other. Treatment parameters, performance status, symptoms prior to treatment, and toxicity were extracted from the electronic medical record. Survival was calculated from the end of RT to last follow-up or death. Seventy-eight patients were included. Median follow-up was 177 days (range, 12-1603). Median age was 64 years old (range, 29-98) and 47 (63%) were male. The main tumor types were melanoma (n = 47) and nonsmall-cell lung cancer (n = 19). Fifty-seven patients were treated with stereotactic radiosurgery (SRS) and 21 with whole-brain radiotherapy (WBRT). Most patients received single-agent ICB, though 4 patients received nivolumab and ipilimumab. Forty-one (53%) patients reported no neurologic toxicity. Grade 2 or greater neurologic toxicities were reported in 12 (21%) and 8 (38%) patients in the SRS and WBRT groups, r...Continue Reading

References

Feb 25, 1999·International Journal of Radiation Oncology, Biology, Physics·M Werner-WasikW J Curran
Oct 13, 2012·International Journal of Radiation Oncology, Biology, Physics·Lia M HalaszRinaa S Punglia
Jan 10, 2014·Cancer Medicine·Ann W SilkChristopher D Lao
Apr 30, 2014·Cancer Immunology Research·Christopher A BarkerJedd D Wolchok
Mar 11, 2015·International Journal of Radiation Oncology, Biology, Physics·Ana P KiessKathryn Beal
Dec 30, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·K A AhmedG T Gibney
Mar 26, 2016·Frontiers in Oncology·Justine V Cohen, Harriet M Kluger
Jul 22, 2016·The Cancer Journal·Eric D BrooksJames W Welsh
Sep 30, 2016·International Journal of Radiation Oncology, Biology, Physics·Susan M HinikerSusan J Knox
Jan 6, 2017·Cancer Treatment Reviews·Stephanie G C KroezeMatthias Guckenberger
May 4, 2017·International Journal of Radiation Oncology, Biology, Physics·Andrew BangJonathan D Schoenfeld
Jun 13, 2017·International Journal of Radiation Oncology, Biology, Physics·Linda ChenLawrence Kleinberg
Jul 1, 2017·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Luke R G PikeJonathan D Schoenfeld
Aug 18, 2017·International Journal of Radiation Oncology, Biology, Physics·Noelle L WilliamsWenyin Shi
Sep 4, 2017·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Daniel M TrifilettiTimothy N Showalter
Jan 30, 2018·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Harper G HubbelingJustin F Gainor
Feb 28, 2018·International Journal of Radiation Oncology, Biology, Physics·Linda ChenKristin J Redmond
Mar 10, 2018·Cancer Immunology, Immunotherapy : CII·Salvatore CaponnettoMarco Donia
Jul 1, 2017·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J B A G HaanenUNKNOWN ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.