Multidisciplinary Management of Brain Metastases from Non-Small Cell Lung Cancer in the Era of Immunotherapy

Sudmeier, Lisa; Tian, Sibo; Higgins, Kristin

doi:10.1007/s11864-021-00871-y

Cited by 6 publications

(7 citation statements)

References 52 publications

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“…Non-small lung cancer (NSCLC) accounts for about 85% of lung malignancies and approximately 20-40% of patients will develop brain metastasis during the course of their disease (1). Current treatment for these patients includes a combination of initial surgical resection if indicated, radiation (stereotactic or whole brain radiotherapy), drug treatment (chemotherapy, target therapy or immunotherapy), or any combination of these modalities (2,3). However, there is yet no strategy to prevent the occurrence of brain metastasis.…”

Section: Introductionmentioning

confidence: 99%

“… 1 Current treatment for these patients includes a combination of initial surgical resection if indicated, radiation (stereotactic or whole brain radiation therapy), drug treatment (chemotherapy, target therapy or immunotherapy), or any combination of these modalities. 2 , 3 However, there is yet no strategy to prevent the occurrence of brain metastasis. TTFields have a multitude of effects on dividing and migrating cancer cells, including mitosis disruption, immunogenic cell death and anti-invasion properties.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modulation of Tumor-Treating Fields by Cerebral Edema from Brain Tumors

Lok¹,

Clark²,

Liang³

et al. 2023

Advances in Radiation Oncology

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modulation of Tumor-Treating Fields by Cerebral Edema from Brain Tumors

Lok¹,

Clark²,

Liang³

et al. 2023

Advances in Radiation Oncology

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“…With the continuous improvement of medical technology, in recent years, immunotherapy, represented by immune checkpoint inhibitors, has been widely favored in the treatment of NSCLC. Immunotherapy can control brain metastases and prolong the survival time of patients with advanced lung cancer [ 7 ]. Camrelizumab is a programmed death receptor 1(PD-1) immune checkpoint inhibitor independently developed by China, which can inhibit the activation of T lymphocytes through the PD-1 pathway and produce a sustained antitumor effect.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Immunotherapy Combined with Radiotherapy in Patients with Brain Metastasis of Driver Gene-Negative Non-Small-Cell Lung Cancer

Zhcang

Zhou

Yin

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Purpose. To observe the remission rate and side effects of immunotherapy combined with radiotherapy in patients with brain metastasis of driver gene-negative non-small-cell lung cancer (NSCLC). Methods. 152 patients with NSCLC brain metastasis admitted to our hospital from January 2019 to December 2021 were selected as the research objects. Patients were divided into a single group (85 cases) and a combined group (67 cases) according to treatment methods. The therapeutic effects and side effects of the single group and combined group were compared. In addition, the patients who received immunotherapy combined with radiotherapy were divided into three subgroups: A, B, and C, and the therapeutic effects and side effects of different radiotherapy modes were compared among group A [whole brain radiotherapy (WBRT)], group B (WBRT combined with local radiotherapy) and group C (local radiotherapy). Results. The objective response rate (ORR) and disease control rate (DCR) in the combined group were higher than those in the single group ( P < 0.05 ). The incidence of reactive capillary hyperplasia and immune-related pneumonia in the combined group were higher than that in the single group ( P < 0.05 ). There was no significant difference in the incidence of other side effects between the two groups ( P > 0.05 ). ORR and DCR in group B were higher than those in group A ( P < 0.05 ). There was no significant difference in the incidence of side effects among the three groups ( P > 0.05 ). Conclusion. Immunotherapy combined with radiotherapy is effective in patients with brain metastasis of driver gene-negative NSCLC, which can improve the disease control rate without increasing the side effects. In addition, WBRT combined with local push radiotherapy is effective and safe. Clinical Study Registration Number. The Clinical study registration number is K2019086.

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“…Alessio Cortellini: Surgical resection represents the recommended first approach to a newly diagnosed symptomatic single brain metastases, especially with large lesions, with diameters greater than 2 cm, like the presented case, as targeted radiation techniques most likely would not have a radical effect (22). A brain MRI should always be performed, to exclude the presence of other lesions and the procedure should be deemed as safe and doable.…”

Section: Several Issues Regarding the Diagnosis And Treatment Of This...mentioning

confidence: 90%

Osimertinib as induction therapy for oligometastatic non-small cell lung cancer with EGFR mutation: a case report

Wu¹,

Ning²,

Li³

et al. 2022

Transl Lung Cancer Res

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Background: The role of surgery in combined modality therapy for selected stage IV oligometastatic (OM) non-small cell lung cancer (NSCLC) is still controversial. Tyrosine kinase inhibitors (TKIs) targeting epidermal growth factor receptor (EGFR) significantly improved the survival in adjuvant therapy in metastatic NSCLC but has rare evidence in inductive setting. This is the first case report about uniportal video-assisted thoracic surgery after induction therapy of TKI for OM-NSCLC. Case Description: A 50-year-old Chinese woman presented to hospital with headache and blurred vision and was diagnosed with an intracranial tumor. The craniotomy confirmed the metastasis from primary lung cancer. Positron emission tomography/computed tomography (PET/CT) showed the mass located in the left upper lobe and left hilar lymph node involvement. Next-generation sequencing found an EGFR mutation (exon 21 p.L858R missense), and osimertinib, a third-generation TKI, was used 80 mg per day as the induction therapy due to the EGFR mutation detected from the metastatic tumor. A favorable treatment response was observed of the lung tumor with lymph node regression, followed by uniportal thoracoscopic left upper lobectomy and systematic lymphadenectomy. The postoperative pathology evaluated both the lung lesion and lymph nodes and confirmed the OM status of this patient. No complications were observed and postoperative osimertinib 80 mg per day continued. Conclusions: Our case suggests that the role of surgery should be appropriately reevaluated for EGFRmutated OM-NSCLC with the emerging development of EGFR-TKI.

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Multidisciplinary Management of Brain Metastases from Non-Small Cell Lung Cancer in the Era of Immunotherapy

Cited by 6 publications

References 52 publications

Modulation of Tumor-Treating Fields by Cerebral Edema from Brain Tumors

Modulation of Tumor-Treating Fields by Cerebral Edema from Brain Tumors

Analysis of Immunotherapy Combined with Radiotherapy in Patients with Brain Metastasis of Driver Gene-Negative Non-Small-Cell Lung Cancer

Osimertinib as induction therapy for oligometastatic non-small cell lung cancer with EGFR mutation: a case report

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