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

Eugene J Vaios; Rachel F Shenker; Peter G Hendrickson; Zihan Wan; Donna Niedzwiecki; David Carpenter; Warren Floyd; Sebastian F Winter; Helen A Shih; Jorg Dietrich; Chunhao Wang; April K S Salama; Jeffrey M Clarke; Karen Allen; Paul Sperduto; Trey Mullikin; John P Kirkpatrick; Scott R Floyd; Zachary J Reitman

doi:10.1001/jamanetworkopen.2025.4347

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

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

Authors

Eugene J Vaios¹, Rachel F Shenker¹, Peter G Hendrickson¹, Zihan Wan², Donna Niedzwiecki³, David Carpenter¹, Warren Floyd⁴, Sebastian F Winter⁵, Helen A Shih⁶, Jorg Dietrich⁵, Chunhao Wang^{1

7}, April K S Salama⁸, Jeffrey M Clarke⁸, Karen Allen¹, Paul Sperduto¹, Trey Mullikin¹, John P Kirkpatrick^{1

9}, Scott R Floyd¹, Zachary J Reitman^{1

9

10}

Affiliations

¹ Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.
² Duke Cancer Institute Biostatistics, Duke University Medical Center, Durham, North Carolina.
³ Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
⁴ Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas.
⁵ Division of Neuro-Oncology, Department of Neurology, Massachusetts General Hospital, Boston.
⁶ Department of Radiation Oncology, Massachusetts General Hospital, Boston.
⁷ Department of Medical Physics, Duke University Medical Center, Durham, North Carolina.
⁸ Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, North Carolina.
⁹ Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
¹⁰ Department of Pathology, Duke University Medical Center, Durham, North Carolina.

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.