Immunotherapy in NSCLC patients with brain metastases. Understanding brain tumor microenvironment and dissecting outcomes from immune checkpoint blockade in the clinic.


Journal

Cancer treatment reviews
ISSN: 1532-1967
Titre abrégé: Cancer Treat Rev
Pays: Netherlands
ID NLM: 7502030

Informations de publication

Date de publication:
Sep 2020
Historique:
received: 12 04 2020
revised: 01 06 2020
accepted: 26 06 2020
pubmed: 19 7 2020
medline: 29 8 2020
entrez: 19 7 2020
Statut: ppublish

Résumé

Brain metastases are frequent complications in patients with non-small-cell lung cancer (NSCLC) associated with significant morbidity and poor prognosis. Our goal is to give a global overlook on clinical efficacy from immune checkpoint inhibitors in this setting and to review the role of biomarkers and molecular interactions in brain metastases from patients with NSCLC. We reviewed clinical trials reporting clinical outcomes of patients with NSCLC with brain metastases as well as publications assessing the tumor microenvironment and the complex molecular interactions of tumor cells with immune and resident cells in brain metastases from NSCLC biopsies or preclinical models. Although limited data are available on immunotherapy in patients with brain metastases, immune checkpoint inhibitors alone or in combination with chemotherapy have shown promising intracranial efficacy and safety results. The underlying mechanism of action of immune checkpoint inhibitors in the brain niche and their influence on tumor microenvironment are still not known. Lower PD-L1 expression and less T CD8 Discordances in the immune profile between primary tumours and brain metastases underscore differences in the tumour microenvironment and immune system interactions within the lung and brain niche. The characterization of immune phenotype of brain metastases and dissecting the interplay among immune cells and resident stromal cells along with cancer cells is crucial to unravel effective immunotherapeutic approaches in patients with NSCLC and brain metastases.

Sections du résumé

BACKGROUND BACKGROUND
Brain metastases are frequent complications in patients with non-small-cell lung cancer (NSCLC) associated with significant morbidity and poor prognosis. Our goal is to give a global overlook on clinical efficacy from immune checkpoint inhibitors in this setting and to review the role of biomarkers and molecular interactions in brain metastases from patients with NSCLC.
METHODS METHODS
We reviewed clinical trials reporting clinical outcomes of patients with NSCLC with brain metastases as well as publications assessing the tumor microenvironment and the complex molecular interactions of tumor cells with immune and resident cells in brain metastases from NSCLC biopsies or preclinical models.
RESULTS RESULTS
Although limited data are available on immunotherapy in patients with brain metastases, immune checkpoint inhibitors alone or in combination with chemotherapy have shown promising intracranial efficacy and safety results. The underlying mechanism of action of immune checkpoint inhibitors in the brain niche and their influence on tumor microenvironment are still not known. Lower PD-L1 expression and less T CD8
CONCLUSIONS CONCLUSIONS
Discordances in the immune profile between primary tumours and brain metastases underscore differences in the tumour microenvironment and immune system interactions within the lung and brain niche. The characterization of immune phenotype of brain metastases and dissecting the interplay among immune cells and resident stromal cells along with cancer cells is crucial to unravel effective immunotherapeutic approaches in patients with NSCLC and brain metastases.

Identifiants

pubmed: 32682248
pii: S0305-7372(20)30105-5
doi: 10.1016/j.ctrv.2020.102067
pii:
doi:

Substances chimiques

Antineoplastic Agents, Immunological 0
B7-H1 Antigen 0
CD274 protein, human 0
PDCD1 protein, human 0
Programmed Cell Death 1 Receptor 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

102067

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. E. Nadal has received honoraria for participating in advisory boards from Bristol Myers Squibb, Merck Sharpe & Dohme, Lilly, Roche, Pfizer, Takeda, Boehringer Ingelheim and AstraZeneca. E. Nadal has received research funding from Roche and Pfizer.J. Bosch-Barrera serves on advisory boards and/or accepted honoraria for giving lectures from Bristol Myers-Squibb (BMS), Roche, Merck Sharp & Dohme (MSD), AstraZeneca, Novartis and Boehringer-Ingelheim. J. Bosch-Barrera has also received grants for research from Pfizer and Roche. All remaining authors have declared no conflicts of interest.

Auteurs

N Vilariño (N)

Department of Medical Oncology, Catalan Institute of Oncology, Hospital Duran i Reynals, Avinguda de la Gran Via de l'Hospitalet, 199-203, L'Hospitalet de Llobregat, Barcelona, Spain; Clinical Research in Solid Tumors (CReST) Group, Molecular Mechanisms and Experimental Therapeutics in Cancer (Oncobell). IDIBELL, Avinguda de la Gran Via de l'Hospitalet, 199-203, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: nvilarino@iconcologia.net.

J Bruna (J)

Neuro-Oncology Unit, Bellvitge University Hospital-ICO (IDIBELL), Avinguda de la Gran Via de l'Hospitalet, 199-203, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: jbruna@bellvitgehospital.cat.

J Bosch-Barrera (J)

Department of Medical Oncology, Catalan Institute of Oncology, Doctor Josep Trueta University Hospital, Avinguda França-Sant Ponç, 0, 17007 Girona, Spain. Electronic address: jbosch@iconcologia.net.

M Valiente (M)

Brain Metastases Group, Spanish National Cancer Research Centre (CNIO), Calle Melchor Fernández Almagro, 3, 28029 Madrid, Spain. Electronic address: mvaliente@cnio.es.

E Nadal (E)

Department of Medical Oncology, Catalan Institute of Oncology, Hospital Duran i Reynals, Avinguda de la Gran Via de l'Hospitalet, 199-203, L'Hospitalet de Llobregat, Barcelona, Spain; Clinical Research in Solid Tumors (CReST) Group, Molecular Mechanisms and Experimental Therapeutics in Cancer (Oncobell). IDIBELL, Avinguda de la Gran Via de l'Hospitalet, 199-203, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: esnadal@iconcologia.net.

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Classifications MeSH