Concurrent administration of Hydroxychloroquine and whole brain radiation therapy for patients with brain metastases

The main purpose of the present study was to evaluate the safety and efficiency of concurrent administration of hydroxychloroquine (HCQ) and whole brain radiation therapy (WBRT) in patients with brain metastases. Based on numerous preclinical reports, inhibition of autophagy by HCQ can significantly enhance the efficacy of DNA-damaging therapies improving results of radiation therapy. The primary end point of this study was response to treatment and complications, determined by the National Cancer Institute Common Toxic Criteria for Adverse Events (CTCAE) scale V5.0.

Patients with pathologically-confirmed primary solid malignancies together with single or multiple brain metastases on magnetic resonance imaging (MRI) were enrolled in the study (n=64). Treatment with HCQ (200 mg/P.O. once daily) was begun concurrent with WBRT (total dose of 30 Grays (Gy) in 10 daily fractions) in case group. Control group received the standard regimen.

Analysis of complications and response rate at each follow up points revealed no statistically significant differences between the case and control groups. Although, median brain metastasis specific Progression Free Survival (PFS) was non-significantly longer in HCQ group compared to control. No grade 3 or more severe toxicities were reported during therapy in both groups of the study.

Although concurrent administration of HCQ with WBRT in patients who suffers from brain metastases was well tolerated, this combination did not meaningfully improve outcomes in comparison to WBRT alone.