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Niu et al. Neuroimmunol Neuroinflammation 2018;5:32 Neuroimmunology and
DOI: 10.20517/2347-8659.2018.39 Neuroinflammation

Review Open Access

Systemic therapy in patients with NSCLC with brain
metastasis: the emerging role of immunotherapy

Jiaxin Niu , Junle Zhou , Sara Lindebak , Fade Mahmoud 1
1
2
1
1 Department of Medical Oncology, Banner MD Anderson Cancer Center, Gilbert, AZ 85234, USA.
2 Department of Pharmacy, Banner MD Anderson Cancer Center, Gilbert, AZ 85234, USA.
Correspondence to: Dr. Jiaxin Niu, Department of Medical Oncology, Banner MD Anderson Cancer Center, 2946 E Banner Gateway
Dr., Gilbert, AZ 85234, USA. E-mail: jiaxin.niu@bannerhealth.com
How to cite this article: Niu J, Zhou J, Lindebak S, Mahmoud F. Systemic therapy in patients with NSCLC with brain metastasis: the
emerging role of immunotherapy. Neuroimmunol Neuroinflammation 2018;5:32. http://dx.doi.org/10.20517/2347-8659.2018.39
Received: 13 Jun 2018 First Decision: 18 Jul 2018 Revised: 6 Aug 2018 Accepted: 7 Aug 2018 Published: 23 Aug 2018

Science Editor: Athanassios P. Kyritsis Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

ABSTRACT
Brain metastasis (BM) is very common in advanced non-small cell lung cancer (NSCLC) patients. The development
of BM remains a serious complication associated with significant morbidity and mortality. The traditional approach
has been largely focusing on local therapy with surgery and/or radiation. New approaches to treat BM in NSCLC
are urgently needed to offer safe and effective therapy as well as to preserve neurocognitive function. There has
been significant progress in development of systemic therapies to treat advanced NSCLC in recent years. Targeted
therapy has been gradually incorporated into clinical practice to manage NSCLC with BM. Immunotherapy (IO) has
revolutionized our treatment paradigm to manage advanced NSCLC. In this review we outline the systemic options
for NSCLC-related BM and discuss IO in NSCLC. Finally, we describe the available data and future perspective to
support the use of IO in NSCLC patients with BM.

Keywords: Immunotherapy, non-small cell lung cancer, brain metastasis

INTRODUCTION
An estimated 1.8 million new lung cancer cases occurred worldwide in 2012, accounting for approximately
13% of total cancer diagnoses. Lung cancer is the leading cause of cancer mortality in both men and women
[1]
in developed countries . Roughly 85% of lung cancers are non-small cell lung cancer (NSCLC) and the
5-year survival rate in stage IV remains less than 5% . Brain metastasis (BM) has long been recognized to
[2]
represent a common event in NSCLC. About 10%-25% of NSCLC patients present with BM upon the initial

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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