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. 2025 Apr 1;8(4):e254347.
doi: 10.1001/jamanetworkopen.2025.4347.

Symptomatic Necrosis With Dual Immune-Checkpoint Inhibition and Radiosurgery for Brain Metastases

Affiliations

Symptomatic Necrosis With Dual Immune-Checkpoint Inhibition and Radiosurgery for Brain Metastases

Eugene J Vaios et al. JAMA Netw Open. .
No abstract available

Plain language summary

This cohort study evaluates whether immune-checkpoint inhibition therapy concurrent with radiosurgery is associated with risk of symptomatic radionecrosis among US patients with brain metastases.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Vaios reported receiving grants from the National Institutes of Health/National Cancer Institute (NIH/NCI) (5R38-CA245204 and 1K38CA292995-01), Duke University Office of Physician Scientist Development, and Duke Cancer Institute P30 Cancer Center Support Grant (NIH/NCI CA014236) during the conduct of the study. Dr Dietrich reported receiving consulting fees from Janssen Pharmaceuticals, Amgen, and Ono Pharmaceuticals outside the submitted work. Dr Salama reported receiving grants from Ascentage, Bristol Myers Squibb, Ideaya, Immunocore, Merck, Olatec Therapeutics, Regeneron, Replimune, and Seagen and serving on the scientific advisory boards of Bristol Myers Squibb, Regeneron, Pfizer, Novartis, and Iovance outside the submitted work. Dr Clarke reported receiving grants from Bristol Myers Squibb, Amgen, Moderna, Adaptimmune, Grid, Spectrum, AstraZeneca, Abel Zeta, Pfizer, and Zai and receiving personal fees from Bristol Myers Squibb, Amgen, Coherus, G1 Therapeutics, CDR Life, BioThera, Abbvie, Sanofi, Merck, AstraZeneca, Pfizer, Spectrum, Genentech, Novartis, Turning Point, Vivacitas, Omega, and Corbus outside the submitted work. Dr Mullikin reported receiving personal fees from Telix Pharmaceuticals and Janssen Pharmaceuticals outside the submitted work. Dr Kirkpatrick reported being an owner of ClearSight RT and receiving grants from LadeRx outside the submitted work. Dr S. R. Floyd reported receiving grants from NIH/NCI during the conduct of the study and serving on the board of directors of as well as owning stock in Round Table Research outside the submitted work. Dr Reitman reported holding a patent for brain tumor diagnostic tests with royalties paid from Genetron Health and managed by Duke University and receiving honoraria for lectures from Eisai Pharmaceuticals and Oakstone Publishing outside the submitted work. No other disclosures were reported.

Figures

Figure.
Figure.. Cumulative Incidence of Symptomatic Radionecrosis (RN) by Immunotherapy Exposure and Timing of Immunotherapy
Concurrent indicates immunotherapy exposure within 30 days of radiosurgery; and ICPI, immune-checkpoint inhibition.

References

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