Uezono H, Nam D, Kluger HM, et al. - A prolonged survival with immune checkpoint inhibitor (ICI) use can be achieved in patients with renal cell carcinoma (RCC) brain metastases (BM) undergoing stereotactic radiosurgery (SRS). Findings demonstrated equally effective local control (LC) of BM was gained in relation to treatment with immunotherapy using a 2 Gy reduction in SRS dose without elevating the risk of central nervous system toxicity.

• This study involved 48 patients with 372 RCC BM.

• They were treated with SRS and split into those ever managed with immunotherapy (n = 29) vs those who never received immunotherapy (n=19).

• Similar demographic and treatment variables were noted except significantly lower median prescribed margin dose in immunotherapy group (20 vs 22 Gy).

• Median overall survival (OS) was 27.2 and 14.9 months in immunotherapy and nonimmunotherapy groups, respectively.

• Even better median OS was found in cases managed with ICI relative to patients who never received ICI (33 vs 16.7 mo).

• Use of ICI and lesion size <1000 mm ³ were linked with improved LC.

• Incidence of radiation necrosis did not differ between the 2 groups.