Cancers, Vol. 12, Pages 2875: Current Multimodality Treatments Against Brain Metastases from Renal Cell Carcinoma

Cancers, Vol. 12, Pages 2875: Current Multimodality Treatments Against Brain Metastases from Renal Cell Carcinoma Cancers doi: 10.3390/cancers12102875 Authors: Yoshiyuki Matsui In patients with renal cell carcinoma, brain metastasis is generally one of the poor prognostic factors. However, the recent introduction of molecular target therapy and immune checkpoint inhibitor has remarkably advanced the systemic treatment of metastatic renal cell carcinoma and prolonged the patients’ survival. The pivotal clinical trials of those agents usually excluded patients with brain metastasis. The incidence of brain metastasis has been increasing in the actual clinical setting because of longer control of extra-cranial disease. Brain metastasis subgroup data from the prospective and retrospective series have been gradually accumulated about the risk classification of brain metastasis and the efficacy and safety of those new agents for brain metastasis. While the local treatment against brain metastasis includes neurosurgery, stereotactic radiosurgery, and conventional whole brain radiation therapy, the technology of stereotactic radiosurgery has been especially advanced, and the combination with systemic therapy such as molecular target therapy and immune checkpoint inhibitor is considered promising. This review summarizes recent progression of multimodality treatment of brain metastasis of renal cell carcinoma from literature data and explores the future direction of th...
Source: Cancers - Category: Cancer & Oncology Authors: Tags: Review Source Type: research

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Randomized controlled trials have failed to report any survival advantage for WBRT combined with SRS in the management of brain metastases, despite the enhanced local and distant control in comparison to each treatment alone. Literature review have revealed important role of primary histology of the tumor when dealing with brain metastases. NSCLC responds better to combined approach even when there was only single brain metastasis present while breast cancer has registered better survival with SRS alone probably due to better response of primary tumor to advancement in surgical and chemotherapeutic agents. Furthermore, mut...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
We report the impact of SAbR on tumor control rates as well as its tolerability in systemic therapy –naïve patients with oligometastatic disease (without brain metastases) and assess the effect of SAbR on subsequent first line systemic therapy by comparison to historical controls.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Clinical Investigation Source Type: research
Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractPurpose of the ReviewBrain metastasis is a common complication of advanced malignancies, especially, lung cancer, breast cancer, renal cell carcinoma, and melanoma. Traditionally surgery, when indicated, and radiation therapy, either as whole-brain radiation therapy or stereotactic radiosurgery, constituted the major treatment options for brain metastases. Until recently, most of the systemic chemotherapy agents had limited activity for brain metastases. However, with the advent of small molecule tyrosine kinase inhibitors and immunotherapy agents, there has been renewed interest in using these agents in the manage...
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research
Patients with metastatic melanoma, renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC) are increasingly treated with immune checkpoint blockade targeting the programed death (PD)-1 receptor, often with palliative radiation therapy. Outcome data are limited in this population.
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original article Source Type: research
CONCLUSIONS: Incorporation of palliative radiation does not preclude favorable outcomes in patients treated with PD-1 inhibitors; patients irradiated after the start of PD-1 inhibition can remain on therapy and demonstrate prolonged survival. Of note, patients irradiated for brain metastases demonstrate favorable outcomes compared with historical controls. PMID: 28662869 [PubMed - as supplied by publisher]
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
Abstract OBJECTIVE The impact of the stereotactic radiosurgery (SRS) prescription dose (PD) on local progression and radiation necrosis for small (≤ 2 cm) brain metastases was evaluated. METHODS An institutional review board-approved retrospective review was performed on 896 patients with brain metastases ≤ 2 cm (3034 tumors) who were treated with 1229 SRS procedures between 2000 and 2012. Local progression and/or radiation necrosis were the primary end points. Each tumor was followed from the date of radiosurgery until one of the end points was reached or the last MRI follow-up. Various criteria were used t...
Source: Journal of Neurosurgery - Category: Neurosurgery Authors: Tags: J Neurosurg Source Type: research
Conclusions The metastatic brain lesions often presented hypoxia showing high FMISO uptake. The lesions with high FMISO uptake were associated with short TTP in the observation periods, although TTD after radiation therapy did not correlate with FMISO uptake. These findings suggest that tumor cells in hypoxic lesions may survive after radiation treatment, possibly shortening TTP regardless of early changes on MRI. In conclusion, FMISO PET may have a potential to predict the local control of treatment in metastatic lesions.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Brain tumors Source Type: research
CONCLUSIONS We describe three patients with SMART presenting with SE. Our cases raise the concern that SMART is not necessarily a migraine phenomenon but can be a form of focal SE associated with stroke-like symptoms. In patients with radiographic suspicion of SMART we suggest a low threshold for vEEG monitoring and aggressive anti-epileptic management.Disclosure: Dr. Fan has nothing to disclose. Dr. Gabriel has nothing to disclose. Dr. Gerard has nothing to disclose. Dr. Schuele has received personal compensation for activities with Sunovion and Eisai as a speaker.
Source: Neurology - Category: Neurology Authors: Tags: Neuromuscular Disease and Epilepsy ePoster Session Source Type: research
Nivolumab has been approved by the Food and Drug Administration to treat advanced non-small cell lung cancer, renal cell carcinoma, and melanoma; however, the impact of nivolumab on brain metastases is unclear.01/28/2016
Source: Kidney Cancer Association - Category: Urology & Nephrology Source Type: news
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