
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.043
vdae090.043
Final Category: Immuno-Oncology Approaches
AcademicSubjects/MED00300
AcademicSubjects/MED00310
IMUN-04 COMBINING CHECKPOINT BLOCKADE AND LASER ABLATION FOR PROGRESSIVE NON-SMALL CELL LUNG CANCER BRAIN METASTASES
Haskell-Mendoza Aden Duke University School of Medicine, Durham, NC, USA

Srinivasan Ethan Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA

Gonzalez Ariel Duke University School of Medicine, Durham, NC, USA

Reason Ellery Duke University School of Medicine, Durham, NC, USA

Jackson Joshua Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA

Wachsmuth Lucas Department of Pathology, Duke University Medical Center, Durham, NC, USA

Lerner Emily Duke University School of Medicine, Durham, NC, USA

Underwood Delaney Department of Bioinformatics and Biostatistics, Duke University School of Medicine, Durham, NC, USA

Buckley Evan Biostatistics Shared Resource, Duke Cancer Institute, Durham, NC, USA

Zaidi Saif Preston Robert Tisch Brain Tumor Center, Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA

II James Herndon Department of Bioinformatics and Biostatistics, Duke University School of Medicine, Durham, NC, USA

Fecci Peter Preston Robert Tisch Brain Tumor Center, Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i14i14
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

BACKGROUND

Laser interstitial thermal therapy (LITT) is a minimally invasive surgical treatment being employed frequently for radiographically progressive brain metastases (BM). Considerable interest exists in combining LITT-mediated in situ vaccination to license immune checkpoint blockade (ICB) and activate an anti-tumor immune response. However, LITT also disrupts the blood-brain barrier, causing transient peritumoral edema. Accordingly, information on safety and feasibility of this combination in BM is needed.

METHODS

All patients receiving LITT for radiographically progressive non-small cell lung carcinoma (NSCLC) BM at a single center from 2015 – 2023 were retrospectively reviewed. Combination therapy was defined as ICB within 6 weeks of LITT. Clinical data, post-LITT freedom from local progression (FFLP), and overall survival (OS) were collected. Adverse events (AEs) were evaluated according to Common Terminology Criteria.

RESULTS

Eighteen patients received LITT + ICB to a total of 19 lesions. Median time between therapies was 2.29 weeks (range 0.85 – 5.98). In comparison to NSCLC patients receiving LITT alone (n = 25), there was no decrement in % ablation (98 vs 95%, P = 0.1), length of stay (1 vs 1 days, P = 0.91), home discharge (100 vs 92%, P = 0.5), or 30-day readmissions (15.8 vs 16%, P = 0.99). Despite decreased preoperative steroid use (P = 0.0098), patients receiving LITT + ICB discontinued steroids at a median of 11 (4 – 147) days post-LITT vs. 24 (3 – 242) days for patients receiving LITT alone (P = 0.62). At study cutoff, 18/19 (94.7%) lesions in the LITT + ICB group and 22/25 (88.0%) in the LITT only group were locally controlled. There were 3 and 5 AEs ≥ Grade 3 in the LITT + ICB and LITT alone group, respectively.

CONCLUSIONS

Combination LITT and ICB does not compromise procedural outcomes and may favorably impact local control in NSCLC. Prospective studies are needed to assess biomarkers of immune response.
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