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https://www.readbyqxmd.com/read/29223987/radiosurgery-for-brain-metastases-changing-practice-patterns-and-disparities-in-the-united-states
#1
Benjamin H Kann, Henry S Park, Skyler B Johnson, Veronica L Chiang, James B Yu
Background: Management of brain metastases typically includes radiotherapy (RT) with conventional fractionation and/or stereotactic radiosurgery (SRS). However, optimal indications and practice patterns for SRS remain unclear. We sought to evaluate national practice patterns for patients with metastatic disease receiving brain RT. Methods: We queried the National Cancer Data Base (NCDB) for patients diagnosed with metastatic non-small cell lung cancer, breast cancer, colorectal cancer, or melanoma from 2004 to 2014 who received upfront brain RT...
December 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29209838/imp3-expression-in-nsclc-brain-metastases-demonstrates-its-role-as-a-prognostic-factor-in-non-neuroendocrine-phenotypes
#2
Alessandro Del Gobbo, Annamaria Morotti, Anna Eleonora Colombo, Valentina Vaira, Giulia Ercoli, Chiara Pesenti, Eleonora Bonaparte, Elena Guerini-Rocco, Andrea Di Cristofori, Marco Locatelli, Alessandro Palleschi, Stefano Ferrero
Brain metastases from NSCLC are associated with a poor prognosis, and local radiotherapy is the most effective therapeutic strategy. The oncofetal protein IMP3 has been studied extensively, and evidence suggests that its expression is related to shorter overall survival and a more aggressive phenotype in solid malignancies. Here, the prognostic role of IMP3 was investigated in a cohort of patients with NSCLC brain metastases in correlation with survival and tumor histotype. A series of 42 NSCLC brain metastases samples was analyzed by tissue microarray and immunohistochemical staining for IMP3...
December 1, 2017: Medical Oncology
https://www.readbyqxmd.com/read/29185589/bevacizumab-and-gefitinib-enhanced-whole-brain-radiation-therapy-for-brain-metastases-due-to-non-small-cell-lung-cancer
#3
R F Yang, B Yu, R Q Zhang, X H Wang, C Li, P Wang, Y Zhang, B Han, X X Gao, L Zhang, Z M Jiang
Non-small-cell lung cancer (NSCLC) patients who experience brain metastases are usually associated with poor prognostic outcomes. This retrospective study proposed to assess whether bevacizumab or gefitinib can be used to improve the effectiveness of whole brain radiotherapy (WBRT) in managing patients with brain metastases. A total of 218 NSCLC patients with multiple brain metastases were retrospectively included in this study and were randomly allocated to bevacizumab-gefitinib-WBRT group (n=76), gefitinib-WBRT group (n=77) and WBRT group (n=75)...
November 17, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/29172778/response-to-afatinib-in-treatment-na%C3%A3-ve-patients-with-advanced-mutant-epidermal-growth-factor-receptor-lung-adenocarcinoma-with-brain-metastases
#4
Shih-Hong Li, Chien-Ying Liu, Ping-Chih Hsu, Yueh-Fu Fang, Chun-Chieh Wang, Kuo-Chin Kao, Li-Chuan Tseng, Cheng-Ta Yang
BACKGROUND: Brain metastases are observable in 20-40% of non-small cell lung cancer patients, but standard treatments for such metastases may be intolerable to some. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) were found to be effective against mutant-EGFR lung adenocarcinomas, but data regarding their effectiveness, especially for the second-generation EGFR-TKI afatinib, is limited. This study compared key outcomes for afatanib monotherapy versus afatinib combined with whole-brain radiotherapy (WBRT) in treatment-naïve lung adenocarcinoma patients harboring EGFR mutations...
December 2, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/29142753/long-term-survival-in-a-patient-with-metastatic-squamous-cell-lung-carcinoma-a-case-report
#5
Emiddio Barletta, Piera Federico, Vincenza Tinessa, Domenico Germano, Lucia Cannella, Teresa Pironti, Bruno Daniele
Non-small-cell lung cancer (NSCLC) is the most common malignancy in industrialized countries, with a 5-year survival rate of only ~15%, as the majority of the patients have advanced-stage disease at diagnosis and the treatment options are limited. Squamous cell carcinoma the second most frequent type of NSCLC and is closely associated with cigarette smoking. We herein present the case of a 72-year-old male smoker, diagnosed with stage IV squamous cell lung carcinoma, with a solitary brain metastasis. After the diagnosis, stereotactic radiotherapy was performed on the brain metastasis...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29111173/epidermal-growth-factor-receptor-mutation-predicts-favorable-outcomes-in-non-small-cell-lung-cancer-patients-with-brain-metastases-treated-with-stereotactic-radiosurgery
#6
Wen-Chi Yang, Furen Xiao, Jin-Yuan Shih, Chao-Chi Ho, Ya-Fang Chen, Ham-Min Tseng, Kuan-Yu Chen, Wei-Yu Liao, Chong-Jen Yu, James Chih-Hsin Yang, Sung-Hsin Kuo, Jason Chia-Hsien Cheng, Pan-Chyr Yang, Feng-Ming Hsu
PURPOSE: The impact of epidermal growth factor receptor (EGFR) mutations on radiotherapy for brain metastases (BM) is undetermined. We evaluated the effects of EGFR mutation status on responses and outcomes in non-small cell lung cancer (NSCLC) patients with BM, treated with upfront or salvage stereotactic radiosurgery (SRS). METHODS AND MATERIALS: From 2008 to 2015, 147 eligible NSCLC patients with 300 lesions were retrospectively analyzed. Patterns of tyrosine kinase inhibitor (TKI) therapy were recorded...
October 27, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29103883/effect-of-brain-metastasis-on-patient-reported-outcomes-in-advanced-nsclc-treated-in-real-world-community-oncology-settings
#7
Mark S Walker, William Wong, Arliene Ravelo, Paul J E Miller, Lee S Schwartzberg
INTRODUCTION: Health-related quality of life (HRQOL) in advanced non-small-cell lung cancer (NSCLC) might be affected by the presence of brain metastasis (BM). We report findings from a prospective observational study that examined HRQOL in patients newly diagnosed with advanced NSCLC, with or without baseline BM, through 1 year of follow-up. PATIENTS AND METHODS: Patients starting first-line treatment of stage IIIB/IV NSCLC were prospectively enrolled and consented at 34 US-based community oncology practices...
October 13, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29069502/predicting-prognosis-of-short-survival-time-after-palliative-whole-brain-radiotherapy
#8
Kazunari Miyazawa, Naoto Shikama, Shohei Okazaki, Tadaaki Koyama, Takao Takahashi, Shingo Kato
Using existing prognostic models, including the Graded Prognostic Assessment (GPA), it is difficult to identify patients with brain metastases (BMs) who are not likely to survive 2 months after whole-brain radiotherapy (WBRT). The purpose of this study was to identify a subgroup of patients who would not benefit clinically from WBRT. We retrospectively reviewed the records of 111 patients with BMs who were ineligible for surgery or stereotactic irradiation and who underwent WBRT between March 2013 and April 2016...
October 24, 2017: Journal of Radiation Research
https://www.readbyqxmd.com/read/29058973/post-recurrence-survival-analysis-of-stage-i-non-small-cell-lung-cancer
#9
Kanghoon Lee, Hyeong Ryul Kim, Dong Kwan Kim, Yong-Hee Kim, Seung-Ill Park, Se Hoon Choi, Junhee Han
Background The aim of this retrospective study was to review recurrence patterns of stage I non-small-cell lung cancer and identify prognostic factors for post-recurrence survival. Methods Among 940 patients with pathological stage I non-small-cell lung cancer who underwent curative resection, 261 experienced a recurrence; of these, 188 had adenocarcinoma and 62 had squamous cell carcinoma. Oligo-recurrence was defined as 1-3 recurrent lesions restricted to a single organ. Potentially curative local treatment included surgery, stereotactic radiotherapy, and photodynamic therapy...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29045549/emerging-treatment-paradigms-in-brain-metastasis-in-non-small-cell-lung-cancer-an-overview-of-the-current-landscape-and-challenges-ahead
#10
D Ulahannan, J Khalifa, C Faivre-Finn, S M Lee
Advances in the last decade in genomic profiling and the identification of druggable targets amenable to biological agents, has transformed the management and survival of a subgroup of patients with brain metastasis in non-small cell lung cancer. In parallel, clinicians have re-evaluated the role of whole brain radiotherapy in selected patients with brain metastases to reduce neurocognitive toxicity. Continual progress in this understudied field is required: optimisation of the sequence of schedules for therapies in patients with brain metastases of differing genomic profiles, focusing on new strategies to overcome mechanisms of biological resistance and increasing drug penetrability into the central nervous system...
October 17, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29037198/prolonged-survival-of-patients-with-egfr-mutated-non-small-cell-lung-cancer-with-solitary-brain-metastases-treated-with-surgical-resection-of-brain-and-lung-lesions-followed-by-egfr-tkis
#11
Qi Gui, Jiangang Liu, Dapeng Li, Chengcheng Xu
BACKGROUND: The standard combination of initial and subsequent treatments of epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) patients with solitary brain metastases (BM) remain unclear. Thus, the management options and the progression-free survival (PFS) and the overall survival (OS) of EGFR-mutated NSCLC patients with solitary BM were investigated in the study. METHODS: We retrospectively reviewed the clinical data from NSCLC patients who harbored EGFR mutations and who presented solitary BM at diagnosis in our institute between 2012 and 2014...
October 16, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28984492/prognostic-factors-affecting-survival-after-whole-brain-radiotherapy-in-patients-with-brain-metastasized-lung-cancer
#12
Georgios Tsakonas, Fatou Hellman, Michael Gubanski, Signe Friesland, Salomon Tendler, Rolf Lewensohn, Simon Ekman, Luigi de Petris
BACKGROUND: Whole-brain radiotherapy (WBRT) has been the standard of care for multiple NSCLC brain metastases but due to its toxicity and lack of survival benefit, its use in the palliative setting is being questioned. PATIENT AND METHODS: This was a single institution cohort study including brain metastasized lung cancer patients who received WBRT at Karolinska University Hospital. Information about Recursive Partitioning Analysis (RPA) and Graded Prognostic Assessment (GPA) scores, demographics, histopathological results and received oncological therapy were collected...
October 6, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28961826/whole-brain-radiotherapy-after-stereotactic-radiosurgery-or-surgical-resection-among-patients-with-one-to-three-brain-metastases-and-favorable-prognoses-a-secondary-analysis-of-eortc-22952-26001
#13
T M Churilla, E Handorf, S Collette, L Collette, Y Dong, A A Aizer, M Kocher, R Soffietti, B M Alexander, S E Weiss
Background: The absence of a survival benefit for whole brain radiotherapy (WBRT) among randomized trials has been attributed to a competing risk of death from extracranial disease. We re-analyzed EORTC 22952 to assess the impact of WBRT on survival for patients with controlled extracranial disease or favorable prognoses. Patients and methods: We utilized Cox regression, landmark analysis, and the Kaplan-Meier method to evaluate the impact of WBRT on survival accounting for (i) extracranial progression as a time-dependent covariate in all patients and (ii) diagnosis-specific graded prognostic assessment (GPA) score in patients with primary non-small-cell lung cancer (NSCLC)...
October 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28881488/case-series-of-pleomorphic-carcinomas-of-the-lung-treated-with-nivolumab
#14
Masaki Kanazu, Takeshi Uenami, Yukihiro Yano, Saeko Nakatsubo, Yuki Hosono, Mikako Ishijima, Yuki Akazawa, Toshihiko Yamaguchi, Koji Urasaki, Masahide Mori, Soichiro Yokota
Pleomorphic carcinoma (PC) of the lung is a rare type of non-small cell lung cancer, exhibiting aggressive behavior and resistance to chemotherapy and radiotherapy. A previous study reported that PCs expressed high levels of PD-L1, suggesting the potential efficacy of immune checkpoint inhibitors in these tumors. We retrospectively reviewed the clinical records of three patients with PC of the lung treated with nivolumab: a 59-year-old woman (Case 1), a 66-year-old man (Case 2), and an 83-year-old man (Case 3)...
November 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28866073/national-trends-in-radiotherapy-for-brain-metastases-at-time-of-diagnosis-of-non-small-cell-lung-cancer
#15
REVIEW
Daniel M Trifiletti, Jason P Sheehan, Surbhi Grover, Sunil W Dutta, Chad G Rusthoven, Brian D Kavanagh, Arjun Sahgal, Timothy N Showalter
BACKGROUND: To analyze the national trends of patients treated radiotherapy for brain metastases from non-small cell lung cancer (NSCLC) that were found at diagnosis. METHODS: The National Cancer Database was queried for patients with NSCLC diagnosed from 2004 to 2013 that received brain irradiation for metastases and patients grouped into having had received fractionated brain radiotherapy (5-15 fractions with or without radiosurgery) or intracranial radiosurgery alone (1-5 fractions)...
November 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28839988/prognostic-significance-of-sites-of-extrathoracic-metastasis-in-patients-with-non-small-cell-lung-cancer
#16
James E Bates, Michael T Milano
BACKGROUND: Metastatic non-small cell lung cancer (NSCLC) continues to have a poor prognosis despite recent advances in both targeted radiotherapy methodologies such as stereotactic body radiotherapy (SBRT) and immunotherapies. The impact of location of metastatic disease in patients with NSCLC has not been investigated; we aimed to investigate this using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: We included 39,910 patients from the SEER database treated for M1b NSCLC from 2010-2013...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28739776/phase-ii-study-of-the-efficacy-and-safety-of-high-dose-pemetrexed-in-combination-with-cisplatin-versus-temozolomide-for-the-treatment-of-non-small-cell-lung-cancer-with-brain-metastases
#17
MULTICENTER STUDY
Qiaowei He, Xizhuang Bi, Chao Ren, Yong Wang, Peng Zou, Hongtao Zhang, Nan Chi, Chunming Xiu, Yunbo Wang, Rongjie Tao
The aim of this study was to explore the efficacy and safety of high-dose pemetrexed with cisplatin versus combination with temozolomide in patients with brain metastases (BM) of lung adenocarcinoma. After standard whole-brain radiotherapy (WBRT, 30 Gy/10 fractions), patients with BM of non-small cell lung cancer (NSCLC) were given high-dose pemetrexed (900 mg/m(2)) on day 1 of each cycle (3 weeks), and cisplatin was administered on days 1-3 in the cisplatin-treated group. The temozolomide-treated group was treated as follows: 75 mg/m(2) temozolomide orally with concurrent WBRT followed by 150 mg/m(2) temozolomide on days 1-5 with high-dose pemetrexed (900 mg/m(2)) on day 1 of each cycle (3 weeks)...
August 2017: Anticancer Research
https://www.readbyqxmd.com/read/28739710/discrepancy-in-programmed-cell-death-ligand-1-between-primary-and-metastatic-non-small-cell-lung-cancer
#18
Shinkichi Takamori, Gouji Toyokawa, Isamu Okamoto, Kazuki Takada, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Takaki Akamine, Masakazu Katsura, Nobutaka Mukae, Fumihiro Shoji, Tatsuro Okamoto, Yoshinao Oda, Toru Iwaki, Koji Iihara, Yoichi Nakanishi, Yoshihiko Maehara
AIM: To investigate the discordance in the programmed cell death-ligand 1 (PD-L1) expression between primary and metastatic tumors and analyze the association between the discordance and the clinical factors in non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS: Twenty-one NSCLC patients who underwent surgery or biopsy for paired primary and metastatic lesions at our Institution from 2005 to 2016 were analyzed. Lesions with the PD-L1 expression being ≥5% were considered PD-L1-positive...
August 2017: Anticancer Research
https://www.readbyqxmd.com/read/28739316/validation-of-the-disease-specific-gpa-for-patients-with-1-to-3-synchronous-brain-metastases-in-newly-diagnosed-nsclc
#19
Neil M Woody, Matthew D Greer, Chandana A Reddy, Gregory M M Videtic, Samuel T Chao, Erin S Murphy, John H Suh, Liliana Angelov, Gene H Barnett, Michael A Vogelbaum, Kevin L Stephans
BACKGROUND: The disease-specific graded prognostic assessment (DS-GPA) for brain metastases is a powerful prognostic tool but has not been validated for patients with synchronous brain metastases (SBM) in newly diagnosed non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: We identified patients with newly diagnosed NSCLC with 1 to 3 SBM treated with stereotactic radiosurgery (SRS) between 1997 and 2012. We included patients whose brain metastases were treated with SRS alone or combined SRS and whole-brain radiotherapy (WBRT)...
July 6, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28739315/combination-therapy-of-radiotherapy-and-anti-pd-1-pd-l1-treatment-in-non-small-cell-lung-cancer-a-mini-review
#20
REVIEW
Shinkichi Takamori, Gouji Toyokawa, Kazuki Takada, Fumihiro Shoji, Tatsuro Okamoto, Yoshihiko Maehara
Immune checkpoint inhibitors against programmed cell death-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) are a standard pharmacologic therapy for patients with non-small-cell lung cancer (NSCLC). Substantial data have accumulated in recent years showing that radiotherapy combined with immunotherapy is more effective than monotherapy alone. Preclinical studies have shown that PD-L1 expression is upregulated on tumor cells after radiotherapy, resulting in the synergistically enhanced antitumor effect of irradiation and PD-L1 blockade...
July 6, 2017: Clinical Lung Cancer
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