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nsclc brain radiotherapy

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28149755/state-of-the-art-of-chemotherapy-for-the-treatment-of-central-nervous-system-metastases-from-non-small-cell-lung-cancer
#11
REVIEW
Alessandro Inno, Vincenzo Di Noia, Ettore D'Argento, Alessandra Modena, Stefania Gori
Chemotherapy is the mainstay of treatment of advanced non-small cell lung cancer (NSCLC) without molecular drivers. Despite a low penetration of central nervous system (CNS), chemotherapy drugs demonstrated encouraging activity against CNS metastases from NSCLC. Based on the available data, chemotherapy should be considered as an important part of the multidisciplinary treatment of CNS metastases. Particularly, platinum-based regimens represent the most active combinations and pemetrexed is associated with a meaningful clinical benefit for patients with non-squamous histology...
December 2016: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28149754/non-small-cell-lung-cancer-nsclc-and-central-nervous-system-cns-metastases-role-of-tyrosine-kinase-inhibitors-tkis-and-evidence-in-favor-or-against-their-use-with-concurrent-cranial-radiotherapy
#12
REVIEW
Panagiota Economopoulou, Giannis Mountzios
Central nervous system (CNS) metastases, including brain metastases (BM) and leptomeningeal metastases (LM) represent a frequent complication of non-small cell lung cancer (NSCLC). Patients with BM comprise a heterogeneous group, with a median survival that ranges from 3 to 14 months. However, in the majority of patients, the occurrence of CNS metastases is usually accompanied by severe morbidity and substantial deterioration in quality of life. Local therapies, such as whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) or surgical resection, either alone or as part of a multimodality treatment are available treatment strategies for BM and the choice of therapy varies depending on patient group and prognosis...
December 2016: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28127743/metachronous-solitary-metastasis-to-the-thyroid-gland-from-squamous-cell-carcinoma-of-the-lung-a-case-report-and-literature-review
#13
Francesco Gelsomino, Giuseppe Lamberti, Valentina Ambrosini, Francesca Sperandi, Roberto Agosti, Alessio G Morganti, Andrea Ardizzoni
INTRODUCTION: Non-small cell lung cancer presents at an advanced stage at diagnosis in two-thirds of cases. The most frequent metastatic sites are the central nervous system, adrenal glands and bones. By contrast, the thyroid gland is an extremely rare site of dissemination. CASE DESCRIPTION: A 64-year-old Caucasian man previously treated with radiosurgery and brain metastasectomy followed by right middle lobectomy for a squamous cell lung carcinoma had a metachronous solitary metastasis to the thyroid gland, as confirmed by fine-needle aspiration cytology and open biopsy...
January 23, 2017: Tumori
https://www.readbyqxmd.com/read/28113019/management-of-brain-metastases-in-tyrosine-kinase-inhibitor-na%C3%A3-ve-epidermal-growth-factor-receptor-mutant-non-small-cell-lung-cancer-a-retrospective-multi-institutional-analysis
#14
William J Magnuson, Nataniel H Lester-Coll, Abraham J Wu, T Jonathan Yang, Natalie A Lockney, Naamit K Gerber, Kathryn Beal, Arya Amini, Tejas Patil, Brian D Kavanagh, D Ross Camidge, Steven E Braunstein, Lauren C Boreta, Suresh K Balasubramanian, Manmeet S Ahluwalia, Niteshkumar G Rana, Albert Attia, Scott N Gettinger, Joseph N Contessa, James B Yu, Veronica L Chiang
Purpose Stereotactic radiosurgery (SRS), whole-brain radiotherapy (WBRT), and epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are treatment options for brain metastases in patients with EGFR-mutant non-small-cell lung cancer (NSCLC). This multi-institutional analysis sought to determine the optimal management of patients with EGFR-mutant NSCLC who develop brain metastases and have not received EGFR-TKI. Materials and Methods A total of 351 patients from six institutions with EGFR-mutant NSCLC developed brain metastases and met inclusion criteria for the study...
April 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28076323/clinical-outcome-of-tyrosine-kinase-inhibitors-alone-or-combined-with-radiotherapy-for-brain-metastases-from-epidermal-growth-factor-receptor-egfr-mutant-non-small-cell-lung-cancer-nsclc
#15
Qianqian Zhu, Yanan Sun, Yingying Cui, Ke Ye, Chengliang Yang, Daoke Yang, Jie Ma, Xiao Liu, Jinming Yu, Hong Ge
This study compared treatment outcomes between TKI monotherapy and TKI administration combined with brain radiotherapy (TKI + RT) in 133 non-small cell lung cancer (NSCLC) patients with brain metastasis (BM). We also evaluated the association of different epidermal growth factor receptor (EGFR) mutation subtypes with treatment outcome. To screen for potential variables affecting cranial progression free survival (PFS) and overall survival (OS), we performed univariate and multivariate analysis based on Cox proportional-hazards models...
February 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/28074321/predictive-factors-of-early-distant-brain-failure-after-gamma-knife-radiosurgery-alone-in-patients-with-brain-metastases-of-non-small-cell-lung-cancer
#16
Young Cheol Na, Hyun Ho Jung, Hye Ryun Kim, Byoung Chul Cho, Jin Woo Chang, Yong Gou Park, Won Seok Chang
The objective of this study was to elucidate the predictive factors for early distant brain failure in patients with brain metastases of non-small-cell lung cancer (NSCLC) who were treated with gamma knife radiosurgery (GKRS) without previous whole-brain radiotherapy (WBRT) or surgery. We retrospectively reviewed clinical and imaging data of 459 patients with brain metastases of NSCLC who underwent GKRS from June 2008 to December 2013. The primary end-point was early distant brain failure, defined as the detection of newly developed metastatic lesions on magnetic resonance imaging (MRI) 3 months after GKRS...
April 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28068937/the-efficacy-and-roles-of-combining-temozolomide-with-whole-brain-radiotherapy-in-protection-neurocognitive-function-and-improvement-quality-of-life-of-non-small-cell-lung-cancer-patients-with-brain-metastases
#17
Xia Deng, Zhen Zheng, Baochai Lin, Huafang Su, Hanbin Chen, Shaoran Fei, Zhenghua Fei, Lihao Zhao, Xiance Jin, Cong-Ying Xie
BACKGROUND: Brain metastasis (BM) is a poor prognostic factor for non-small-cell lung cancer (NSCLC). The efficacy and roles of combining temozolomide (TMZ) with whole brain radiotherapy (WBRT) in protection neurocognitive function (NCF) and improvement quality of life (QOL) were investigated and compared with WBRT alone in the treatment of NSCLC patients with BM. METHODS: A total of 238 NSCLC patients with BM were reviewed and categorized into WBRT plus TMZ (RCT) arm and WBRT alone (RT), respectively...
January 10, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28066650/whole-brain-radiotherapy-for-brain-metastases-from-non-small-cell-lung-cancer-the-end-of-an-era
#18
COMMENT
Anna M E Bruynzeel, Frank J Lagerwaard
No abstract text is available yet for this article.
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28031389/systemic-therapy-of-brain-metastases-non-small-cell-lung-cancer-breast-cancer-and-melanoma
#19
REVIEW
Marc C Chamberlain, Christina S Baik, Vijayakrishna K Gadi, Shailender Bhatia, Laura Q M Chow
Brain metastases (BM) occur frequently in many cancers, particularly non-small cell lung cancer (NSCLC), breast cancer, and melanoma. The development of BM is associated with poor prognosis and has an adverse impact on survival and quality of life. Commonly used therapies for BM such as surgery or radiotherapy are associated with only modest benefits. However, recent advances in systemic therapy of many cancers have generated considerable interest in exploration of those therapies for treatment of intracranial metastases...
January 2017: Neuro-oncology
https://www.readbyqxmd.com/read/27998469/-epidermal-growth-factor-tyrosine-kinase-inhibitors-used-in-the-treatment-of-nsclc-patients-with-leptomeningeal-metastasis
#20
Y Xu, W Zhong, J Zhao, M J Chen, L Zhang, L Y Li, M Z Wang
Objective: The aim of this study was to identify the clinical features and prognostic factors of leptomeningeal metastasis (LM) in non-small cell lung cancer (NSCLC) patients undergoing treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs). Methods: Twenty-five cases of NSCLC with LM, treated in our hospital during January 1, 2003 to October 31, 2013, were enrolled in this study. Medical records were reviewed for clinical features and treatments, and the survival and prognostic factors were analyzed...
December 23, 2016: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
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