{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T16:00:40Z","timestamp":1775059240656,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Growing evidence suggests that immunotherapy has a positive effect on non\u2013small cell lung cancer (NSCLC) patients with brain metastases (BMs). However, it remains unclear which type of immunotherapy is more efficient. The aim of this network meta\u2010analysis (NMA) was to compare the efficacy and safety of different immunotherapy types and determine the optimal option.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Four databases (PubMed, Cochrane Library databases, Embase, and Web of Science) and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrial.gov\">ClinicalTrial.gov<\/jats:ext-link> were searched from inception until January 26, 2023. Randomized controlled trials (RCTs), prospective nonrandomized trials, or observational studies investigating NSCLC patients with BMs treated by immunotherapy were included. The quality of the included studies was evaluated using the Cochrane risk of bias (ROB) tool and the Newcastle\u2010Ottawa Scale (NOS). The efficacy of immunotherapy on NSCLC patients with BMs was evaluated using frequentist random\u2010effects NMA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>Eleven studies from 1560 citations, encompassing 1437 participants, were included in this NMA. Statistical analysis showed that pembrolizumab (SMD\u2009=\u20094.35, 95% CI [2.21, 6.60]) and nivolumab+ipilimumab (SMD\u2009=\u20093.81, 95% CI [1.21, 6.40]) could improve overall survival (OS). Pembrolizumab (SMD\u2009=\u20093.32, 95% CI [2.75, 3.90]) demonstrated better effects in improving the overall response rate (ORR). No significant difference in adverse event (AE) was observed between immunotherapy and chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicated that pembrolizumab was the most promising immunotherapy for NSCLC patients with BMs. Nivolumab+ipilimumab might be an alternative choice to improve OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Limitation<\/jats:title><jats:p>Inconsistency tests were not performed because of the scarcity of direct comparison. Besides, high heterogeneity was observed in our NMA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.13823","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T08:39:31Z","timestamp":1724143171000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparative Efficacy and Safety of Immunotherapy on Non\u2013Small Cell Lung Cancer Patients With Brain Metastases: A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7108-5687","authenticated-orcid":false,"given":"Tianyi","family":"Lyu","sequence":"first","affiliation":[{"name":"Acupuncture Department Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Sun","sequence":"additional","affiliation":[{"name":"Asset Management Division Beijing University of Chinese Medicine Third Affiliated Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daowen","family":"Yang","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xirui","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Acupuncture\u2010Moxibustion and Tuina Beijing University of Chinese Medicine  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruoshui","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Acupuncture\u2010Moxibustion and Tuina Beijing University of Chinese Medicine  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyang","family":"Shu","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demin","family":"Li","sequence":"additional","affiliation":[{"name":"National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Surgical Department Dongfang Hospital Beijing University of Chinese Medicine  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-011-0203-y"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0055-y"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/jop.19.00357"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13665-018-0215-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2016.03.009"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.07.016"},{"key":"e_1_2_10_8_1","first-page":"1392","article-title":"Treatment for Brain Metastases: ASCO\u2010SNO\u2010ASTRO Guideline. 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