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nsclc brain radiotherapy

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https://www.readbyqxmd.com/read/28726172/combined-treatment-for-non-small-cell-lung-cancer-and-breast-cancer-patients-with-brain-metastases-with-whole-brain-radiotherapy-and-temozolomide-a-systematic-review-and-meta-analysis
#1
REVIEW
Jingru Tian, Yien Luo, Juanjuan Xiang, Jingqun Tang
Brain metastasis is the leading cause of death among advanced non-small cell lung cancer (NSCLC) and breast cancer patients. The standard treatment for brain metastases is radiotherapy. The combination of radiotherapy and chemotherapy has been tested. However, the management of brain metastases has yet to be successful. Here, we aimed to determine the efficacy and safety of whole brain radiotherapy (WBRT) alone or in combination with temozolomide (TMZ) in NSCLC and breast cancer patients with brain metastases...
July 19, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28712276/optimal-dose-and-volume-for-postoperative-radiotherapy-in-brain-oligometastases-from-lung-cancer-a-retrospective-study
#2
Seung Yeun Chung, Jong Hee Chang, Hye Ryun Kim, Byoung Chul Cho, Chang Geol Lee, Chang-Ok Suh
PURPOSE: To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume. MATERIALS AND METHODS: Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ± boost (WBRT ± boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13)...
June 2017: Radiation Oncology Journal
https://www.readbyqxmd.com/read/28693798/brain-metastases-from-non-small-cell-lung-carcinoma-changing-concepts-for-improving-patients-outcome
#3
REVIEW
Chloé Rancoule, Alexis Vallard, Jean-Baptiste Guy, Sophie Espenel, Peng Diao, Cyrus Chargari, Nicolas Magné
The management of Non Small Cell Lung Cancer (NSCLC) brain metastases is challenging, as this frequent complication negatively impacts patients' quality of life, and can be a life-threatening event. Through a review of the literature, we discuss the main therapeutic options and the recent developments that improved (and complicated) the management of NSCLC brain metastases patients. Most current validated approaches are local with exclusive or combined surgery, whole brain radiotherapy (WBRT) and stereotactic radiotherapy (SRT)...
August 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28687923/lapatinib-with-whole-brain-radiotherapy-in-patients-with-brain-metastases-from-breast-and-non-small-cell-lung-cancer-a-phase-ii-study-of-the-hellenic-cooperative-oncology-group-hecog
#4
Christos Christodoulou, Anna Kalogera-Fountzila, Vasilios Karavasilis, George Kouvatseas, Christos N Papandreou, Epaminontas Samantas, Kalliopi Varaki, Georgios Papadopoulos, Mattheos Bobos, Grigorios Rallis, Evangelia Razis, Athina Goudopoulou, Konstantine T Kalogeras, Konstantinos N Syrigos, George Fountzilas
Small molecules, mainly tyrosine kinase inhibitors, are currently used in various malignancies. Lapatinib, a dual inhibitor of EGFR/HER2 tyrosine kinases, has demonstrated effectiveness in brain metastases from HER2-overexpressing breast cancer. It also appears to sensitize EGFR-expressing cell lines to radiation. To evaluate the efficacy of lapatinib in combination with whole brain radiotherapy (WBRT) in patients with brain metastases from non-small cell lung cancer (NSCLC) and breast cancer, as assessed by volumetric analysis by MRI...
July 7, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28669848/isolated-brain-metastases-as-the-first-relapse-after-the-curative-surgical-resection-in-non-small-cell-lung-cancer-patients-with-an-egfr-mutation
#5
Shinko Sadoyama, Akimasa Sekine, Hiroaki Satoh, Tae Iwasawa, Terufumi Kato, Satoshi Ikeda, Masafumi Sata, Tomohisa Baba, Erina Tabata, Yuko Minami, Kenji Nemoto, Kenji Hayashihara, Takefumi Saito, Koji Okudela, Kenichi Ohashi, Michihiko Tajiri, Takashi Ogura
INTRODUCTION: The aim of this study was to clarify the incidence and disease behavior of brain metastases (BM) without extracranial disease (ie, isolated BM) as the first relapse after curative surgery in non-small-cell lung cancer (NSCLC) patients, analyzed according to epidermal growth factor receptor (EGFR) mutation status. PATIENTS AND METHODS: A review of the medical charts of consecutive NSCLC patients diagnosed between 2005 and 2016 with BM as the first relapse after curative surgery was performed...
June 1, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28651600/validation-of-the-graded-prognostic-assessment-for-lung-cancer-with-brain-metastases-using-molecular-markers-lung-molgpa
#6
Carsten Nieder, Mandy Hintz, Oliver Oehlke, Angelika Bilger, Anca L Grosu
BACKGROUND: Many patients with brain metastases from non-small cell lung cancer have limited survival, while others survive for several years, depending on patterns of spread, EGFR and ALK alterations, among others. The purpose of this study was to validate a new prognostic model (Lung-molGPA) originally derived from a North American database. PATIENTS AND METHODS: This retrospective study included 269 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy...
June 26, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28595434/radiotherapy-for-brain-metastases-near-the-end-of-life-in-an-integrated-health-care-system
#7
Joan J Ryoo, Michael Batech, Chengyi Zheng, Raymond W Kim, Michael K Gould, A Robert Kagan, Winston W Lien
BACKGROUND: To examine radiotherapy (RT) patterns-of-care and utilization at the end of life (EOL) among non-small cell lung cancer (NSCLC) patients with brain metastasis (BrM) in an integrated health care system. METHODS: Central tumor registry identified 5,133 patients diagnosed with NSCLC from 2007-2011. BrM were determined by imaging. Patient and clinical characteristics were obtained by chart abstraction. In addition to abstracted variables, graded prognostic assessment (GPA) score of 0-1 was derived by collected data and tested as a predictor of death within 14 or 30 days of RT...
April 15, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28586934/brain-metastases-of-non-small-cell-lung-cancer-prognostic-factors-in-patients-with-surgical-resection
#8
Aida Ramos Antuña, Marco Alvarez Vega, Carmen Rodriguez Sanchez, Vanesa Martin Fernandez
Background and Study Aims Bronchogenic carcinoma is the cancer that most commonly metastasizes to the brain. The standard treatment schedule for these patients is still unclear, although recommendation level 1 class I advocates for surgical resection together with postoperative whole-brain radiotherapy for patients with good Karnofsky performance status (KPS). We performed a study to identify prognostic factors for the long-term survival of patients with brain metastases from non-small cell lung cancer (NSCLC)...
June 6, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28555261/paradigm-shift-of-therapeutic-management-of-brain-metastases-in-egfr-mutant-non-small-cell-lung-cancer-in-the-era-of-targeted-therapy
#9
REVIEW
Akimasa Sekine, Hiroaki Satoh
Non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations commonly present brain metastases (BM) at the time of NSCLC diagnosis or during the clinical course. Conventionally, the prognosis of BM has been extremely poor, but the advent of EGFR-tyrosine kinase inhibitors (TKIs) has drastically improved the prognosis in these patients. Despite the presence of the blood-brain barrier, EGFR-TKIs have dramatic therapeutic effects on both BM and extracranial disease. In addition, recent systemic chemotherapies reportedly play a role in controlling BM...
July 2017: Medical Oncology
https://www.readbyqxmd.com/read/28540256/concurrent-afatinib-and-whole-brain-radiotherapy-in-exon-19-del-egfr-mutant-lung-adenocarcinoma-a-case-report-and-mini-review-of-the-literature
#10
Chukwuka Eze, Nina-Sophie Hegemann, Olarn Roengvoraphoj, Maurice Dantes, Farkhad Manapov
Leptomeningeal metastases (LM) are found in approximately 3.8% of non-small cell lung cancer cases with an increased incidence in adenocarcinoma, and approximately one-third of patients will present with concomitant brain metastases. We report the case of a 50-year-old male patient with stage IV exon 19-del-EGFR mutant lung adenocarcinoma who progressed on second-generation TKI therapy with manifestation of symptomatic simultaneous diffuse brain and LM. Whole-brain radiotherapy with concurrent afatinib resulted in an almost complete regression of neurological symptoms as well as good, durable radiological response...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28520828/targeted-therapy-as-an-alternative-to-whole-brain-radiotherapy-in-egfr-mutant-or-alk-positive-non-small-cell-lung-cancer-with-brain-metastases
#11
Pablo Martínez, Raymond H Mak, Geoffrey R Oxnard
Clinical Question: Is up-front whole-brain radiotherapy required to treat multiple brain metastases from non-small-cell lung cancer when highly active targeted therapies are available? Clinical Application: Patients with EGFR-mutant or ALK-positive non-small-cell lung cancer with brain metastases now have the potential to achieve a prolonged survival. Through use of highly active targeted therapies, whole-brain radiotherapy can be safely postponed, diminishing toxic effects that could impair quality of life...
May 18, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28490938/comparative-survival-in-patients-with-brain-metastases-from-non-small-cell-lung-cancer-treated-before-and-after-implementation-of-radiosurgery
#12
J N Greenspoon, P M Ellis, G Pond, S Caetano, J Broomfield, A Swaminath
INTRODUCTION: Survival after a diagnosis of brain metastasis in non-small-cell lung cancer (nsclc) is generally poor. We previously reported a median survival of approximately 4 months in a cohort of patients treated with whole-brain radiotherapy (wbrt). Since that time, we implemented a program of stereotactic radiosurgery (srs). In the present study, we examined survival and prognostic factors in a consecutive cohort of patients after the introduction of the srs program. METHODS: Data from a retrospective review of 167 nsclc patients with brain metastasis referred to a tertiary cancer centre during 2010-2012 were compared with data from a prior cohort of 91 patients treated during 2005-2007 ("pre-srs cohort")...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28391420/a-neuro-oncologist-s-perspective-on-management-of-brain-metastases-in-patients-with-egfr-mutant-non-small-cell-lung-cancer
#13
REVIEW
Tresa McGranahan, Seema Nagpal
Management of non-small cell lung cancer (NSCLC) with brain metastasis (BrM) has been revolutionized by identification of molecular subsets that have targetable oncogenes. Historically, survival for NSCLC with symptomatic BrM was weeks to months. Now, many patients are surviving years with limited data to guide treatment decisions. Tumors with activating mutations in epidermal growth factor receptor (EGFRact+) have a higher incidence of BrM, but a longer overall survival. The high response rate of both systemic and BrM EGFRact+ NSCLC to tyrosine kinase inhibitors (TKIs) has led to the rapid incorporation of new therapies but is outpacing evidence-based decisions for BrM in NSCLC...
April 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28391295/diagnosis-and-treatment-of-brain-metastases-from-solid-tumors-guidelines-from-the-european-association-of-neuro-oncology-eano
#14
Riccardo Soffietti, Ufuk Abacioglu, Brigitta Baumert, Stephanie E Combs, Sara Kinhult, Johan M Kros, Christine Marosi, Philippe Metellus, Alexander Radbruch, Salvador S Villa Freixa, Michael Brada, Carmine M Carapella, Matthias Preusser, Emilie Le Rhun, Roberta Rudà, Joerg C Tonn, Damien C Weber, Michael Weller
The management of patients with brain metastases has become a major issue due to the increasing frequency and complexity of the diagnostic and therapeutic approaches. In 2014, the European Association of Neuro-Oncology (EANO) created a multidisciplinary Task Force to draw evidence-based guidelines for patients with brain metastases from solid tumors. Here, we present these guidelines, which provide a consensus review of evidence and recommendations for diagnosis by neuroimaging and neuropathology, staging, prognostic factors, and different treatment options...
February 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28377206/ablative-therapy-for-oligometastatic-non-small-cell-lung-cancer
#15
REVIEW
Oscar Juan, Sanjay Popat
The oligometastatic state represents a distinct entity among those with metastatic disease and consists of patients with metastases limited in number and location, representing an intermediate state between locally confined and widely metastatic cancer. Although similar, "oligorecurrence" (limited number of metachronous metastases under conditions of a controlled primary lesion) and "oligoprogressive" (disease progression at a limited number of sites with disease controlled at other disease sites) states are distinct entities...
March 14, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28363487/treatment-options-for-patients-with-brain-metastases-from-egfr-alk-driven-lung-cancer
#16
Mark K Doherty, Grzegorz J Korpanty, Pascale Tomasini, Moein Alizadeh, Kevin Jao, Catherine Labbé, Celine M Mascaux, Petra Martin, Suzanne Kamel-Reid, Ming-Sound Tsao, Melania Pintilie, Geoffrey Liu, Penelope A Bradbury, Ronald Feld, Natasha B Leighl, Caroline Chung, Frances A Shepherd
INTRODUCTION: Brain metastases in EGFR/ALK-driven NSCLC frequently pose treatment dilemmas. Tyrosine kinase inhibitors (TKIs) can control extracranial disease, but radiotherapy is often required for intracranial control. We aimed to evaluate the impact of first-line whole brain radiotherapy (WBRT), stereotactic radiotherapy (SRS) or TKI alone on outcomes of patients with brain metastases from EGFR/ALK-driven NSCLC. METHODS: This single center retrospective review included 184 patients with brain metastases from EGFR/ALK-driven NSCLC, and analyzed effect of treatment choice on time to intracranial progression (TTIP) and overall survival (OS)...
May 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28285695/optimal-management-of-alk-positive-nsclc-progressing-on-crizotinib
#17
REVIEW
Giulio Metro, Marco Tazza, Roberta Matocci, Rita Chiari, Lucio Crinò
Crizotinib is an anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitor (-TKI) that represents the standard first-line treatment of patients with ALK-rearranged (ALK-positive) advanced non-small cell lung cancer (NSCLC). In this setting, crizotinib has demonstrated a response rate of roughly 75% and a median progression-free survival just under one year. However, acquired resistance will emerge in virtually all crizotinib-treated patients, whose management may require a diversified approach according to the pace of the disease and/or the site(s) of disease progression...
April 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28178168/rapid-intracranial-response-to-osimertinib-without-radiotherapy-in-nonsmall-cell-lung-cancer-patients-harboring-the-egfr-t790m-mutation-two-case-reports
#18
Taro Koba, Takashi Kijima, Takayuki Takimoto, Haruhiko Hirata, Yujiro Naito, Masanari Hamaguchi, Tomoyuki Otsuka, Muneyoshi Kuroyama, Izumi Nagatomo, Yoshito Takeda, Hiroshi Kida, Atsushi Kumanogoh
RATIONALE: Most of nonsmall cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) activating mutations eventually acquire resistance to the first EGFR-tyrosine kinase inhibitors (TKIs) therapy after varying periods of treatment. Of note, approximately one-third of those patients develop brain metastases, which deteriorate their quality of life and survival. The effect of systemic chemotherapy on brain metastases after acquisition of EGFR-TKI resistance is limited, and thus far, whole-brain radiation therapy, which may cause the harmful effect on neurocognitive functions, has been the only established therapeutic option for especially symptomatic brain metastases...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28174381/-effectiveness-of-nivolumab-in-large-cell-neuroendocrine-carcinoma-of-the-lung-a-report-of-two-cases
#19
REVIEW
Wakako Daido, Masahiro Yamasaki, Naomi Saito, Sayaka Ishiyama, Naoko Deguchi, Masaya Taniwaki, Haruko Daga, Nobuyuki Ohashi
BACKGROUND: The anti-programmed death-1 antibody nivolumab is an important treatment option for non-small-cell lung carcinoma.However, its effectiveness for large-cell neuroendocrine carcinomas(LCNEC)is still controversial.Here, we report 2 cases of LCNECs that responded to nivolumab.Case 1: A 62-year-old man received chemotherapy and radiotherapy for stage III A lung adenocarcinoma.One year later, another lung lesion was observed and diagnosed as LCNEC using surgical lung biopsy.Although he subsequently received some chemotherapy regimens, the patient developed new brain metastasis, expanded mediastinal lesion, and increased levels of the tumor marker pro-gastrin releasing peptide(ProGRP)...
January 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28149766/unexpected-long-survival-of-brain-oligometastatic-non-small-cell-lung-cancer-nsclc-treated-with-multimodal-treatment-a-single-center-experience-and-review-of-the-literature
#20
Concetta Elisa Onesti, Daniela Iacono, Silvia Angelini, Salvatore Lauro, Marco Mazzotta, Mario Alberto Occhipinti, Raffaele Giusti, Paolo Marchetti
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide. Fifty percent of the cases are metastatic at diagnosis and about 20% develop brain metastasis. The brain involvement represents a negative prognostic factor. However, some patients could benefit from locoregional treatments of metastatic foci and experience an unexpected long survival or healing. In the previous years some classifications were proposed to identify patients' prognostic category, according to stage of the primary tumor, the timing of metastases occurrence (synchronous or metachronous) and the number of metastatic sites...
December 2016: Translational Lung Cancer Research
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