Advances in Immune Checkpoint Inhibitors for the Treatment of Non-Small-Cell Lung Cancer with Central Nervous System Metastases: A Review

Central nervous system (CNS) metastasis represents a severe complication in pa-tients with advanced non-small cell lung cancer (NSCLC), significantly impacting both quality of life and prognosis. Immune checkpoint inhibitor (ICI)-based regimens have emerged as promising therapeutic options for NSCLC patients lacking actionable genetic alterations. Large-scale clinical trials and real-world studies are progressing in this field. Increasing clini-cal evidence suggests that ICIs exhibit favorable efficacy and safety in treating NSCLC with CNS metastasis, particularly showing enhanced activity in patients with high programmed death-ligand 1(PD-L1) expression levels (≥50%). This article aimed to review the therapeutic progress of ICI-based management of NSCLC with CNS involvement, covering systemic treatment strategies of ICIs combined with chemotherapy and multimodal treatment plans combining ICIs with radiotherapy and chemotherapy. By summarizing the results of existing large-scale clinical studies, the goal was to provide a phased summary for the clinical treatment of advanced NSCLC with CNS metastasis and propose ideas for future research directions.