Efficacy and safety of combining bevacizumab and fractionated stereotactic radiotherapy for extensive brain metastases in patients with non‐small cell lung cancer: a prospective phase II study (GASTO‐1053)

作者：Rui Zhou, ShiYang Zheng, Daquan Wang, Fang Dong, Hongmei Zhang, Tao Zhang, QiaoTing Luo, Biaoshui Liu, Hui Liu, Hui Liu, Jun Zhang, Fangjie Liu, Bin Wang, Likun Chen, Yonggao Mou, Kangqiang Peng, Bo Qiu, Hui Liu, Hui Liu · 发表于：癌症：英文版 · 年份：2025 · DOI：10.1002/cac2.70078 · 被引用次数：3 · 研究领域：Brain Metastases and Treatment、Lung Cancer Research Studies、Lung Cancer Treatments and Mutations

BACKGROUND: The prognosis for non-small cell lung cancer (NSCLC) patients with extensive brain metastases (BMs) treated with radiotherapy alone remains poor. Based on the synergistic potential of radiotherapy and angiogenesis inhibitors, we initiated this phase II study to assess the efficacy and safety of combining bevacizumab (Bev) with fractionated stereotactic radiotherapy (FSRT) in managing extensive BMs in NSCLC patients who had stable extracranial disease. METHODS: Patients with extensive BMs from NSCLC, deemed unsuitable for stereotactic radiosurgery, were prospectively enrolled following multidisciplinary tumor board evaluation. Patients received FSRT (40 Gy in 10 fractions or 30 Gy in 5 fractions) in combination with Bev (7.5 mg/kg on day 1 prior to FSRT and on day 21 post-FSRT). The primary endpoint was intracranial progression-free survival (IPFS). Secondary endpoints included overall survival, progression-free survival, quality of life (QOL), and toxicities. For comparison, NSCLC patients with extensive BMs treated with whole-brain radiotherapy (WBRT) plus FSRT or FSRT alone were matched 1:1 with the study group (Bev + FSRT) using the propensity score matching. RESULTS: One hundred and six patients were included in the Bev + FSRT group, with a median follow-up duration of 35.8 months. The median IPFS was 18.3 months (95% confidence interval, 15.2-23.3 months). The Bev + FSRT group showed a significant improvement in IPFS compared to both the WBRT + FSRT group (9....