Combination of Atezolizumab, Bevacizumab, and Chemotherapy (IMpower 150) in a Patient With NSCLC Having Leptomeningeal Metastases

Remón, Jordi; Castro-Henriques, María; Esteller, Laura; Vives, Josep Maria Muñoz

doi:10.1016/j.jtocrr.2020.100096

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…In addition to ICI monotherapy and chemoimmunotherapy, the combination of VEGF receptor targeted agent and chemoimmunotherapy represents another first-line treatment option for advanced NSCLC based on the IMpower150 study ( 84 ). A post hoc analysis evaluated the efficacy outcomes in patients with KRAS , STK11(LKB1) , and KEAP1 mutations ( 81 ).…”

Section: Kras G12cmentioning

confidence: 99%

Immunotherapy in Non-Small Cell Lung Cancer With Actionable Mutations Other Than EGFR

et al. 2021

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While first line targeted therapies are the current standard of care treatment for non-small cell lung cancer (NSCLC) with actionable mutations, the cancer cells inevitably acquire resistance to these agents over time. Immune check-point inhibitors (ICIs) have improved the outcomes of metastatic NSCLC, however, its efficacy in those with targetable drivers is largely unknown. In this manuscript, we reviewed the published data on ICI therapies in NSCLC with ALK, ROS1, BRAF, c-MET, RET, NTRK, KRAS, and HER2 (ERBB2) alterations. We found that the objective response rates (ORRs) associated with ICI treatments in lung cancers harboring the BRAF (0–54%), c-MET (12–49%), and KRAS (18.7-66.7%) alterations were comparable to non-mutant NSCLC, whereas the ORRs in RET fusion NSCLC (less than10% in all studies but one) and ALK fusion NSCLC (0%) were relatively low. The ORRs reported in small numbers of patients and studies of ROS1 fusion, NTRK fusion, and HER 2 mutant NSCLC were 0–17%, 50% and 7–23%, respectively, making the efficacy of ICIs in these groups of patients less clear. In most studies, no significant correlation between treatment outcome and PD-L1 expression or tumor mutation burden (TMB) was identified, and how to select patients with NSCLC harboring actionable mutations who will likely benefit from ICI treatment remains unknown.

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Section: Kras G12cmentioning

confidence: 99%

Immunotherapy in Non-Small Cell Lung Cancer With Actionable Mutations Other Than EGFR

et al. 2021

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“…In the setting of LMD related to breast cancer, a chemotherapeutic sensitizing effect of bevacizumab has been suggested [ 28 ]. Combination of bevacizumab with checkpoint inhibitor atezolizumab for treatment of LMD related to lung cancer has also been reported [ 29 ]. Combination of ICIs with anti-angiogenic therapy such as bevacizumab may have a synergistic effect in tumor control [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Proton craniospinal irradiation with bevacizumab and pembrolizumab for leptomeningeal disease: a case report

et al. 2023

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Leptomeningeal disease (LMD) remains a challenging condition with a dismal prognosis. In this case study, we report partial response of LMD in a patient with metastatic large cell neuroendocrine carcinoma following treatment with proton craniospinal irradiation (CSI), bevacizumab, and pembrolizumab. Two years after the initial diagnosis, he presented with LMD. He underwent proton CSI with bevacizumab followed by combination therapy with pembrolizumab and bevacizumab. He had a partial disease response with progression-free survival after LMD diagnosis of 4.6 months. He unfortunately developed pembrolizumab induced hypophysitis, after which he experienced rapid neurologic clinical progression. Overall, this novel combination led to a durable partial response which warrants prospective evaluation.

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“…IMpower 150: In the phase 3 randomized clinical trial, atezolizumab was added to the chemotherapy regimen as a firstline treatment of patients with leptomeningeal metastases [62].…”

Section: Fda Approved Treatmentsmentioning

confidence: 99%

Current options for the treatment of advanced or metastatic NSCLC

Lee

2023

Second International Conference on Biological Engineering and Medical Science (ICBioMed 2022)

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Non-small cell lung cancer (NSCLC) remains the predominate cause of cancer-related death worldwide. The estimate in the last decade indicates that for patients with metastatic NSCLC, the overall 5-year survival rate is only 7%. It is worthy that molecular target therapies or immunotherapy enable patients with metastatic lung cancer to prolong overall survival and associated with less frequent adverse events. However, chemotherapy alone, such as docetaxel, is correlated with limited efficacy and inevitable toxicity. Although cytotoxic chemotherapy still plays a vital role in cancer interventions, the biomarker-directed therapies that target the molecular alterations or programmed cell death 1 (PD-L1) and programmed cell ligand 1 (PD-1) pathways have substituted for chemotherapy as the standard first-line or second-line therapies for nearly half of patients with advanced NSCLC. An identifiable biomarker that predicts the efficacy of immune checkpoint blockades and tyrosine kinase inhibitors (TKIs) is necessary to determine the patients who most probably benefit from immunotherapy. Evaluating the PD-L1 expression level and workable molecular alterations may be the best prediction indicator for efficacy in NSCLC. This review summarizes the effectiveness in current clinical trials guiding the patients with NSCLC using checkpoint blockades and TKIs as first-line treatment, evaluating the survival efficacy of PD-L1 expression level in selected patients treated with checkpoint blockades. Sixty-three articles about clinical trials of immunotherapy for NSCLC were identified from PubMed. All included articles were published from January 1, 2007, to January 30, 2021, and divided into different PD-L1 expression levels to analyze survival.

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Combination of Atezolizumab, Bevacizumab, and Chemotherapy (IMpower 150) in a Patient With NSCLC Having Leptomeningeal Metastases

Cited by 6 publications

References 9 publications

Immunotherapy in Non-Small Cell Lung Cancer With Actionable Mutations Other Than EGFR

Immunotherapy in Non-Small Cell Lung Cancer With Actionable Mutations Other Than EGFR

Proton craniospinal irradiation with bevacizumab and pembrolizumab for leptomeningeal disease: a case report

Current options for the treatment of advanced or metastatic NSCLC

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