Cemiplimab monotherapy as first-line treatment of patients with brain metastases from advanced non–small cell lung cancer with programmed cell death-ligand 1 ≥50%

Kilickap S., ÖZGÜROĞLU M., Sezer A., Gümüş M., Bondarenko I., Gogishvili M., ...Daha Fazla

Cancer, cilt.131, sa.10, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 131 Sayı: 10
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1002/cncr.35864
  • Dergi Adı: Cancer
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, PASCAL, Abstracts in Social Gerontology, BIOSIS, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Public Affairs Index, Veterinary Science Database
  • Anahtar Kelimeler: advanced NSCLC, brain metastases, cemiplimab, immunotherapy, PD-L1
  • Bezmiâlem Vakıf Üniversitesi Adresli: Evet

Özet

Background: In the phase 3 EMPOWER-Lung 1 study, first-line cemiplimab monotherapy provided significant survival benefit versus chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with programmed cell death-ligand 1 (PD-L1) ≥50%. This exploratory subgroup analysis investigated the clinical outcomes of cemiplimab treatment in patients with advanced NSCLC with brain metastases. Methods: Patients with advanced NSCLC were randomized (1:1) to cemiplimab 350 mg every 3 weeks or four cycles of platinum doublet chemotherapy (NCT03088540). Patients with symptomatic radiotherapy-treated brain metastases were eligible to enroll. Of the 565 patients with confirmed PD-L1 expression ≥50%, 69 (12%) had brain metastases at baseline. Results: Patients with brain metastases who received cemiplimab had a median overall survival (OS) of 52.4 months compared with 20.7 months for those who received chemotherapy (hazard ratio [HR], 0.40; p =.0031) and a median progression-free survival (PFS) of 12.5 versus 5.3 months (HR, 0.33; p =.0002), respectively. Patients without brain metastases had a median OS of 24.3 months with cemiplimab versus 12.5 months with chemotherapy (HR, 0.63; p <.0001); their median PFS was 6.5 months versus 5.2 months (HR, 0.55; p <.0001), respectively. Cemiplimab was associated with a significant improvement in global health status/quality of life in all patients, including those with brain metastases. The cemiplimab safety profile was generally similar in all patients. Conclusions: In patients with advanced NSCLC with PD-L1 ≥50%, first-line cemiplimab monotherapy improved survival and patient-reported outcomes over chemotherapy for those who received prior radiotherapy for symptomatic brain metastases.