Background: Little is known about the efficacy of programmed cell death protein-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) inhibitors in patients with central nervous system (CNS) metastases.
Objective: This study aimed to assess the difference in efficacy of PD-1 or PD-L1 inhibitors in patients with and without CNS metastases.
Methods: From inception to March 2020, PubMed and Embase were searched for randomized controlled trials (RCTs) about PD-1 or PD-L1 inhibitors. Only trails with available hazard ratios (HRs) for overall survival (OS) of patients with and without CNS metastases simultaneously would be included. Overall survival hazard ratios and their 95% confidence interval (CI) were calculated, and the efficacy difference between these two groups was assessed in the meantime.
Results: A total of 4988 patients (559 patients with CNS metastases and 4429 patients without CNS metastases) from 8 RCTs were included. In patients with CNS metastases, the pooled HR was 0.76 (95%CI, 0.62 to 0.93), while in patients without CNS metastases, the pooled HR was 0.74 (95%CI, 0.68 to 0.79). There was no significant difference in efficacy between these two groups (χ=0.06 P=0.80).
Conclusion: With no significant heterogeneity observed between patients with or without CNS metastases, patients with CNS metastases should not be excluded in the PD-1 or PD-L1 blockade therapy. Future research should permit more patients with CNS metastases to engage in PD-1 or PDL1 blockade therapy and explore the safety of PD-1 or PD-L1 inhibitors in patients with CNS metastases.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.2174/1568009621666210601111811 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Intraventricular Administration of Exosomes from Patients with Amyotrophic Lateral Sclerosis Provokes Motor Neuron Disease in Mice.
Acta Naturae
January 2024
Research Center of neurology, Ministry of Science and Higher Education of the Russian Federation, Moscow, 125367 Russian Federation.
Amyotrophic lateral sclerosis (ALS) is a severe disease of the central nervous system (CNS) characterized by motor neuron damage leading to death from respiratory failure. The neurodegenerative process in ALS is characterized by an accumulation of aberrant proteins (TDP-43, SOD1, etc.) in CNS cells.
View Article and Find Full Text PDFIDH-mutant gliomas in children and adolescents - from biology to clinical trials.
Front Oncol
January 2025
Department of Pediatric and Adolescent Oncology/Hematology, Perth Children's Hospital, Nedlands, WA, Australia.
Gliomas account for nearly 30% of all primary central nervous system (CNS) tumors in children and adolescents and young adults (AYA), contributing to significant morbidity and mortality. The updated molecular classification of gliomas defines molecularly diverse subtypes with a spectrum of tumors associated with age-distinct incidence. In adults, gliomas are characterized by the presence or absence of mutations in isocitrate dehydrogenase (), with mutated (mIDH) gliomas providing favorable outcomes and avenues for targeted therapy with the emergence of mIDH inhibitors.
View Article and Find Full Text PDFEarly diagnosis of cryptococcal meningoencephalitis in HIV-negative patients: Integration of brain MRI and clinical findings.
eNeurologicalSci
March 2025
Department of Neurology, Brain Research Institute, Niigata University, Japan.
Purpose: Cryptococcal meningoencephalitis (CM) in human immunodeficiency virus (HIV)-negative patients are often diagnosed later than in HIV-infected patients, which increases mortality rates concerning the former. Consequently, early diagnosis and treatment are crucial for improving clinical prognosis in HIV-negative patients. This study investigated the utility of magnetic resonance imaging (MRI) in combination with clinical and laboratory findings for early diagnosis of CM in HIV-negative patients.
View Article and Find Full Text PDFAbnormal cardiovascular control during exercise: Role of insulin resistance in the brain.
Auton Neurosci
January 2025
Departments of Applied Clinical Research, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. Electronic address:
During exercise circulatory adjustments to meet oxygen demands are mediated by multiple autonomic mechanisms, the skeletal muscle exercise pressor reflex (EPR), the baroreflex (BR), and by feedforward signals from central command neurons in higher brain centers. Insulin resistance in peripheral tissues includes sensitization of skeletal muscle afferents by hyperinsulinemia which is in part responsible for the abnormally heightened EPR function observed in diabetic animal models and patients. However, the role of insulin signaling within the central nervous system (CNS) is receiving increased attention as a potential therapeutic intervention in diseases with underlying insulin resistance.
View Article and Find Full Text PDFExperience of an advanced practice nurse in an intensive care unit.
Enferm Intensiva (Engl Ed)
January 2025
Área de Críticos, Clínica Universidad de Navarra, Spain. Electronic address:
The intensive care units structure, the technological improvement and the severity of the patients, require that there be harmony between all the actors involved in assisting the critically ill patient. Added to this context is that the current role of the supervisor involves assuming more and more management skills, without losing sight of the need to frame professional practice within the framework of a philosophy of care. Given this challenge for the supervisor, the appearance in our environment of the Advance Practice Nurse figure (APN) is an opportunity.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!