Management Paradigm of Central Nervous System Metastases in NSCLC: An Australian Perspective
JTO Clin Res Rep. 2023 Jul 26;4(9):100553. doi: 10.1016/j.jtocrr.2023.100553. eCollection 2023 Sep.ABSTRACTLife-prolonging central nervous system active systemic therapies for metastatic NSCLC have increased the complexity of managing brain metastases (BMs). Australian medical oncologists, radiation oncologists, and neurosurgeons discussed the evidence guiding the diverse clinical approaches to the management of BM in NSCLC. The Australian context is broadly applicable to other jurisdictions; therefore, we have documented these discussions as principles with broader applications. Patient management was stratified according to clinical and radiologic factors under two broad classifications of newly diagnosed BMs: symptomatic and asymptomatic. Other important considerations include the number and location of metastases, tumor histotypes, molecular subtype, and treatment purpose. Careful consideration of the pace and burden of symptoms, risk of worsening neurologic function at a short interval, and extracranial disease burden should determine whether central nervous system active systemic therapies are used alone or in combination with local therapies (surgery with or without radiation therapy). Most clinical trial evidence currently focuses on historical treatment options or a single treatment modality rather than the optimal sequencing of multiple modern therapies; therefore, an individualized approach is key in a rapidly changing therapeutic landscape.PMID:37663675 | PMC:PMC1...
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Chee Khoon Lee Yu Yang Soon Rosalind L Jeffree Rohit Joshi Eng-Siew Koh Wei-Sen Lam Hien Le Zarnie Lwin Mark B Pinkham Shankar Siva Evan Ng Thomas John Source Type: research
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