[Research Progress in the Treatment of Brain Metastases  from Non-small Cell Lung Cancer]

Overview

Journal Zhongguo Fei Ai Za Zhi

Specialties Oncology
Pulmonary Medicine

Date 2020 Dec 28

PMID 33357316

Citations 3

Authors

Xue Han

Hongmei Li

Affiliations

Soon will be listed here.

Abstract

Lung cancer is the leading cause of cancer-related deaths worldwide. The most common pathological type of lung cancer is non-small cell lung cancer (NSCLC). The incidence of brain metastases caused by NSCLC has been on the rise. Brain metastasis seriously affects the patient's cognitive function, survival time and quality of life, and the prognosis is extremely poor. The natural course of the disease is about 1 mon-3 mon. After treatment, the median survival time is only 3 mon-6 mon, the one year survival rate is 14%, and the two years survival rate is only 7.6%. The location, number, and size of brain metastases are related to their symptoms and survival. Patients with central nervous system symptoms have a worse prognosis. The goal of brain metastasis treatment is to optimize overall survival and quality of life, and to prioritize the preservation of neurocognitive functions. At present, the main treatments for brain metastases in NSCLC include radiotherapy, surgery, chemotherapy, molecular targeting, and immunotherapy. Clinically, it is necessary to conduct a multidisciplinary assessment of the best treatment methods for patients according to the heterogeneity of patients (clinical characteristics, pathological types, tissue types, etc). This article aims to review the research progress of current treatment methods. .

Citing Articles

Impact of lung adenocarcinoma subtypes on survival and timing of brain metastases.

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Efficacy of different therapies for brain metastases of non-small cell lung cancer: a systematic review and meta-analysis.

Chen M, Wei L, Wang Q, Xie J, Xu K, Lv T Transl Lung Cancer Res. 2023; 12(4):689-706.

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

Zhang Q, Zhou S, Yin H, Zhu C, Li D, Li X Evid Based Complement Alternat Med. 2022; 2022:1193075.

PMID: 36225182 PMC: 9550440. DOI: 10.1155/2022/1193075.

References

Reungwetwattana T, Nakagawa K, Cho B, Cobo M, Cho E, Bertolini A . CNS Response to Osimertinib Versus Standard Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients With Untreated EGFR-Mutated Advanced Non-Small-Cell Lung Cancer. J Clin Oncol. 2018; :JCO2018783118. DOI: 10.1200/JCO.2018.78.3118. View

Li W, Yu H . Separating or combining immune checkpoint inhibitors (ICIs) and radiotherapy in the treatment of NSCLC brain metastases. J Cancer Res Clin Oncol. 2019; 146(1):137-152. DOI: 10.1007/s00432-019-03094-9. View

Yamamoto M, Serizawa T, Higuchi Y, Sato Y, Kawagishi J, Yamanaka K . A Multi-institutional Prospective Observational Study of Stereotactic Radiosurgery for Patients With Multiple Brain Metastases (JLGK0901 Study Update): Irradiation-related Complications and Long-term Maintenance of Mini-Mental State Examination.... Int J Radiat Oncol Biol Phys. 2017; 99(1):31-40. DOI: 10.1016/j.ijrobp.2017.04.037. View

Noronha V, Patil V, Joshi A, Menon N, Chougule A, Mahajan A . Gefitinib Versus Gefitinib Plus Pemetrexed and Carboplatin Chemotherapy in -Mutated Lung Cancer. J Clin Oncol. 2019; 38(2):124-136. DOI: 10.1200/JCO.19.01154. View

Wu Y, Ahn M, Garassino M, Han J, Katakami N, Kim H . CNS Efficacy of Osimertinib in Patients With T790M-Positive Advanced Non-Small-Cell Lung Cancer: Data From a Randomized Phase III Trial (AURA3). J Clin Oncol. 2018; 36(26):2702-2709. DOI: 10.1200/JCO.2018.77.9363. View

Ulahannan D, Khalifa J, Faivre-Finn C, Lee S . Emerging treatment paradigms for brain metastasis in non-small-cell lung cancer: an overview of the current landscape and challenges ahead. Ann Oncol. 2017; 28(12):2923-2931. DOI: 10.1093/annonc/mdx481. View

Sperduto P, Yang T, Beal K, Pan H, Brown P, Bangdiwala A . Estimating Survival in Patients With Lung Cancer and Brain Metastases: An Update of the Graded Prognostic Assessment for Lung Cancer Using Molecular Markers (Lung-molGPA). JAMA Oncol. 2016; 3(6):827-831. PMC: 5824323. DOI: 10.1001/jamaoncol.2016.3834. View

Wang S, Li J . Second-generation EGFR and ErbB tyrosine kinase inhibitors as first-line treatments for non-small cell lung cancer. Onco Targets Ther. 2019; 12:6535-6548. PMC: 6700283. DOI: 10.2147/OTT.S198945. View

Wrona A . Management of CNS disease in ALK-positive non-small cell lung cancer: Is whole brain radiotherapy still needed?. Cancer Radiother. 2019; 23(5):432-438. DOI: 10.1016/j.canrad.2019.03.009. View

10.

Magnuson W, Yeung J, Guillod P, Gettinger S, Yu J, Chiang V . Impact of Deferring Radiation Therapy in Patients With Epidermal Growth Factor Receptor-Mutant Non-Small Cell Lung Cancer Who Develop Brain Metastases. Int J Radiat Oncol Biol Phys. 2016; 95(2):673-9. DOI: 10.1016/j.ijrobp.2016.01.037. View

11.

Lan Q, Ji C, Yao Y . [Basis of Tumor Microenvironment Relevant to Immunotherapies for Brain Metastases of NSCLC]. Zhongguo Fei Ai Za Zhi. 2019; 22(8):512-519. PMC: 6717868. DOI: 10.3779/j.issn.1009-3419.2019.08.06. View

12.

Hartford A, Paravati A, Spire W, Li Z, Jarvis L, Fadul C . Postoperative stereotactic radiosurgery without whole-brain radiation therapy for brain metastases: potential role of preoperative tumor size. Int J Radiat Oncol Biol Phys. 2012; 85(3):650-5. DOI: 10.1016/j.ijrobp.2012.05.027. View

13.

Zeng Y, Liao H, Qin T, Zhang L, Wei W, Liang J . Blood-brain barrier permeability of gefitinib in patients with brain metastases from non-small-cell lung cancer before and during whole brain radiation therapy. Oncotarget. 2015; 6(10):8366-76. PMC: 4480758. DOI: 10.18632/oncotarget.3187. View

14.

Herbst R, Baas P, Kim D, Felip E, Perez-Gracia J, Han J . Pembrolizumab versus docetaxel for previously treated, PD-L1-positive, advanced non-small-cell lung cancer (KEYNOTE-010): a randomised controlled trial. Lancet. 2015; 387(10027):1540-1550. DOI: 10.1016/S0140-6736(15)01281-7. View

15.

Miyamoto S, Nomura R, Sato K, Awano N, Kuse N, Inomata M . Nivolumab and stereotactic radiation therapy for the treatment of patients with Stage IV non-small-cell lung cancer. Jpn J Clin Oncol. 2018; 49(2):160-164. DOI: 10.1093/jjco/hyy171. View

16.

Zustovich F, Ferro A, Lombardi G, Farina P, Zagonel V . Bevacizumab-Based Therapy for Patients with Brain Metastases from Non-Small-Cell Lung Cancer: Preliminary Results. Chemotherapy. 2015; 60(5-6):294-9. DOI: 10.1159/000376605. View

17.

Kim D, Mehra R, Tan D, Felip E, Chow L, Camidge D . Activity and safety of ceritinib in patients with ALK-rearranged non-small-cell lung cancer (ASCEND-1): updated results from the multicentre, open-label, phase 1 trial. Lancet Oncol. 2016; 17(4):452-463. PMC: 5063047. DOI: 10.1016/S1470-2045(15)00614-2. View

18.

Shi Y, Sun Y, Yu J, Ding C, Ma Z, Wang Z . [China Experts Consensus on the Diagnosis and Treatment of Brain Metastases of Lung Cancer (2017 version)]. Zhongguo Fei Ai Za Zhi. 2017; 20(1):1-13. PMC: 5973287. DOI: 10.3779/j.issn.1009-3419.2017.01.01. View

19.

Soffietti R, Abacioglu U, Baumert B, Combs S, Kinhult S, Kros J . Diagnosis and treatment of brain metastases from solid tumors: guidelines from the European Association of Neuro-Oncology (EANO). Neuro Oncol. 2017; 19(2):162-174. PMC: 5620494. DOI: 10.1093/neuonc/now241. View

20.

Gadgeel S, Peters S, Mok T, Shaw A, Kim D, Ou S . Alectinib versus crizotinib in treatment-naive anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer: CNS efficacy results from the ALEX study. Ann Oncol. 2018; 29(11):2214-2222. PMC: 6290889. DOI: 10.1093/annonc/mdy405. View

[Research Progress in the Treatment of Brain Metastases from Non-small Cell Lung Cancer]

[Research Progress in the Treatment of Brain Metastases  from Non-small Cell Lung Cancer]