{
  "abstract": "Background Immunotherapy can prolong survival in a variety of cancers, including lung cancer, but can also trigger immune-related adverse events (irAEs). Patients who experience irAEs may have prolonged overall survival and progression-free survival. However, the impact of irAEs in lung cancer patients with brain metastases remains uncharacterized.Methods We conducted a retrospective, single-institution analysis of patients with primary lung malignancy who received immunotherapy and developed synchronous or metachronous brain metastases. Data on treatment patterns, demographics, survival outcomes and irAEs were collected. Median survival times were estimated using the Kaplan-Meier method. Hazard ratios (HR) were from multivariable Cox regression models, and associated p-values were calculated from Wald tests. Number of brain metastases, timing of brain metastases, 1st line therapy for lung cancer diagnosis, treatment after CNS metastases, and whether a patient experienced an irAE were used as covariates in the multivariable analyses.Results Of 599 lung cancer patients who received immunotherapy at our center, 221 developed brain metastases. The median age was 62.0 years, 49.8% were male, and 80.5% were White. 66.1% had adenocarcinoma, 13.6% had squamous cell carcinoma, 10.4% had small cell carcinoma, and 2.7% had neuroendocrine tumors. 66.1% of patients had synchronous brain metastases. 66.5% of patients had 1-5 brain metastases, 15.4% had 5-10, and 12.2% had > 10 brain metastases. 80.5% of patients received systemic and locoregional treatment after diagnosis of brain metastases. 49.3% of patients experienced an irAE; there was no significant difference in age, stage at diagnosis, or cancer histology between the irAE and non-irAE groups (p > 0.05). Median overall survival (OS) was 24.3 months (95% CI: 18.7-35.2 months). Patients with irAE had prolonged CNS-progression free survival (HR = 0.66, p = 0.008) and OS (HR = 0.51, p < 0.001) compared to patients who did not develop irAE.Conclusions Development of an irAE was associated with improved CNS progression-free-survival and overall survival in lung cancer patients with brain metastases. More work is needed to further elucidate factors associated with irAE and reasons for improved survival outcomes in this patient population.",
  "authors": [
    {
      "affiliations": [
        "University of Virginia School of Medicine, Charlottesville, VA, USA"
      ],
      "name": "Susanna D’Silva"
    },
    {
      "affiliations": [
        "University of Virginia, Charlottesville, VA, USA"
      ],
      "name": "Mu-hsun Chen"
    },
    {
      "affiliations": [
        "University of Virginia, Charlottesville, VA, USA"
      ],
      "name": "Zhu Hong"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA"
      ],
      "name": "Omar Elghawy"
    },
    {
      "affiliations": [
        "University of Virginia, Charlottesville, VA, USA"
      ],
      "name": "Varinder Kaur"
    }
  ],
  "title": "1035 Implications of immune-related adverse events on survival in lung cancer patients with brain metastases",
  "uid": "de1d291b-2ebc-520d-b03b-982bd8f7a574"
}