Dr Parma on Survival Outcomes With Immunotherapy in Patients With NSCLC Brain Metastases

"This was a good topic to choose from, because…a lot of the clinical trials that led to approval for immunotherapy in metastatic NSCLC [did not include] a lot of patients who had brain metastases. Specifically looking at a cohort of just patients with brain metastases and [evaluating] how they did with immunotherapy was a good question to ask."

Mitchell Parma, MD, a clinical fellow in Hematology/Oncology at the University of Texas MD Anderson Cancer Center, highlighted key points from an analysis of survival benefit with immunotherapy in patients with NSCLC brain metastases, which was presented by a colleague at Mayo Clinic Florida during the 2025 ASCO Annual Meeting. The discussion took place as part of the OncLive Fellows Forum on Thoracic Oncology, which convened trainees from across the United States to examine emerging research in the field.

Parma noted that the abstract addressed an important knowledge gap, as many pivotal clinical trials leading to immunotherapy approvals in metastatic NSCLC underrepresented patients with brain metastases. By focusing specifically on this subgroup, the analysis sought to provide a clearer picture of real-world outcomes in this high-risk population, Parma explained.

The analysis included data from several institutions, encompassing over 1,000 patients with NSCLC and brain metastases who received immunotherapy, he detailed. The findings demonstrated a statistically significant improvement in overall survival among these patients, supporting the clinical benefit of immunotherapy in this setting and strengthening existing but previously less robust evidence, Parma reported.

Prognostic factors associated with improved or poorer survival outcomes were also evaluated, he continued. Notably, an unexpected finding emerged: non-White patients appeared to derive greater benefit from immunotherapy than White patients, Parma stated. He emphasized that this observation runs counter to previous research, which has consistently highlighted racial disparities in cancer care delivery and clinical trial enrollment. This outcome may be attributed to the disproportionately small number of non-White patients included in the dataset, potentially limiting the generalizability of this finding, Parma suggested, emphasizing that no inferences can be drawn at this time.