Systemic and intracranial activity of antibody-drug conjugates in patients with non-small cell lung cancer and brain metastases: A systematic review and meta-analysis.
Susu Zhou, Jiayi Tan, Vishw Patel et al.
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In 30 seconds
This systematic review and meta-analysis assessed systemic and intracranial responses to antibody-drug conjugates (ADCs) in patients with non-small cell lung cancer and brain metastases. Across 13 studies including 3,191 patients, 905 of whom had brain metastases, pooled intracranial objective response was 33% (95% CI: 25-43%), and intracranial disease control was 78%. Systemic objective response was 40% (95% CI: 30-52%). Systemic response did not differ significantly between patients with and without brain metastases (pooled odds ratio, 1.00; 95% CI, 0.67-1.49; p = 1.00).
Key findings
- Pooled intracranial objective response was 33% (95% CI: 25-43%), with an intracranial disease control rate of 78%.
- Pooled systemic objective response was 40% (95% CI: 30-52%), and systemic disease control was 77%.
- HER2-targeted ADCs had systemic and intracranial objective response rates of 54% and 44%, respectively.
- Systemic objective response did not significantly differ by brain metastasis status (pooled odds ratio, 1.00; 95% CI, 0.67-1.49; p = 1.00).
Why it matters
Brain metastases are a major challenge in NSCLC, and patients with them have been underrepresented in clinical trials. The pooled findings indicate that ADC activity can extend to intracranial disease, providing evidence relevant to treatment discussions for this population while highlighting the need to assess outcomes by ADC target and patient characteristics.
What to keep in mind
The review pooled results from 13 studies, and the abstract does not specify their designs or establish that the evidence comes from randomised comparisons.