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Cancer Immunology, Immunotherapy

, Volume 67, Issue 5, pp 703–711 | Cite as

Cancer immunotherapy in patients with brain metastases

  • Salvatore Caponnetto
  • Arianna Draghi
  • Troels Holz Borch
  • Marianna Nuti
  • Enrico Cortesi
  • Inge Marie Svane
  • Marco Donia
Review

Abstract

The exclusion of “real-world” patients from registration clinical trials of cancer immunotherapy represents a significant emerging issue. For instance, a large fraction of cancer patients develops brain metastases during the course of the disease, but results from large prospective clinical trials investigating this considerable proportion of the cancer patient population are currently lacking. To provide a useful tool for the clinician in a “real-world” setting, we have reviewed the available literature regarding the safety and efficacy of immune check-point inhibitors in patients with cancer metastatic to the brain. Overall, these data provide encouraging evidence that these therapeutic agents can induce intracranial objective responses, particularly in patients with asymptomatic and previously untreated brain metastases. Larger prospective studies are needed to confirm these initial results.

Keywords

Cancer immunotherapy Brain metastases Check-point inhibitors Ipilimumab Nivolumab Pembrolizumab 

Abbreviations

CR

Complete response

DCR

Disease control rate

FDA

US Food and Drug Administration

Ipi

Ipilimumab

irRC

Immune-related response criteria

nivo

Nivolumab

NSCLC

Non-small cell lung cancer

OR

Objective response

ORR

Objective response rate

pembro

Pembrolizumab

PFS

Progression-free survival

PR

Partial response

RN

Radiation necrosis

SD

Stable disease

Notes

Compliance with ethical standards

Conflict of interest

Marco Donia has received honoraria for lectures from Bristol-Myers Squibb, Merck, Astra Zeneca, and Genzyme; and financial support for attending symposia from Bristol-Myers Squibb, Merck, Novartis, Pfizer, and Roche. Inge Marie Svane has received honoraria for consultancies and lectures from Novartis, Roche, Merck, and Bristol-Myers Squibb; a restricted research grant from Novartis; and financial support for attending symposia from Bristol-Myers Squibb, Merck, Novartis, Pfizer, and Roche. All other authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Salvatore Caponnetto
    • 1
    • 2
  • Arianna Draghi
    • 3
  • Troels Holz Borch
    • 3
    • 4
  • Marianna Nuti
    • 2
  • Enrico Cortesi
    • 1
  • Inge Marie Svane
    • 3
    • 4
  • Marco Donia
    • 3
    • 4
  1. 1.Cell Therapy Unit and Laboratory of Tumor Immunology, Department of Experimental Medicine, Policlinico Umberto ISapienza University of RomeRomeItaly
  2. 2.Division of Medical Oncology B, Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto ISapienza University of RomeRomeItaly
  3. 3.Center for Cancer Immune Therapy (CCIT), Department of Hematology, Herlev HospitalUniversity of CopenhagenHerlevDenmark
  4. 4.Department of Oncology, Herlev HospitalUniversity of CopenhagenHerlevDenmark

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