Focal Radiotherapy of Brain Metastases in Combination With Immunotherapy and Targeted Drug Therapy

Dtsch Arztebl Int. 2021 Nov 12;(Forthcoming):arztebl.m2021.0332. doi: 10.3238/arztebl.m2021.0332. Online ahead of print.ABSTRACTBACKGROUND: Advances in systemic treatment and in brain imaging have led to a higher incidence of diagnosed brain metastases. In the treatment of brain metastases, stereotactic radiotherapy and radiosurgery, systemic immunotherapy, and targeted drug therapy are important evidence-based options. In this review, we summarize the available evidence on the treatment of brain metastases of the three main types of cancer that give rise to them: non-small-cell lung cancer, breast cancer, and malignant melanoma.METHODS: This narrative review is based on pertinent original articles, meta-analyses, and systematic reviews that were retrieved by a selective search in PubMed. These publications were evaluated and discussed by an expert panel including radiation oncologists, neurosurgeons, and oncologists.RESULTS: There have not yet been any prospective randomized trials concerning the optimal combination of local stereotactic radiotherapy/radiosurgery and systemic immunotherapy or targeted therapy. Retrospective studies have consistently shown a benefit from early combined treatment with systemic therapy and (in particular) focal radiotherapy, compared to sequential treatment. Two metaanalyses of retrospective data from cohorts consisting mainly of patients with non-small-cell lung cancer and melanoma revealed longer overall survival after combined treatment with...
Source: Deutsches Arzteblatt International - Category: General Medicine Authors: Source Type: research

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J Clin Oncol. 2021 Dec 21:JCO2102314. doi: 10.1200/JCO.21.02314. Online ahead of print.ABSTRACTPURPOSE: To provide guidance to clinicians regarding therapy for patients with brain metastases from solid tumors.METHODS: ASCO convened an Expert Panel and conducted a systematic review of the literature.RESULTS: Thirty-two randomized trials published in 2008 or later met eligibility criteria and form the primary evidentiary base.RECOMMENDATIONS: Surgery is a reasonable option for patients with brain metastases. Patients with large tumors with mass effect are more likely to benefit than those with multiple brain metastases and/o...
Source: Clinical Breast Cancer - Category: Cancer & Oncology Authors: Source Type: research
This study assessed the presentation and institutional outcomes treating brain metastases (BM) of breast cancer (BC), non-small cell lung cancer (NSCLC), and melanoma origin.METHODS: Patients with brain metastases treated between 2014 and 2019 with primary melanoma, NSCLC, and BC were identified. Overall survival (OS) was calculated from dates of initial BM diagnosis using the Kaplan-Meier method.RESULTS: A total of 959 patients were identified including melanoma (31%), NSCLC (51%), and BC (18%). Patients with BC were younger at BM diagnosis (median age: 57) than NSCLC (65) and melanoma patients (62, p
Source: Cell Research - Category: Cytology Authors: Source Type: research
ConclusionsOverall, BM indicates poor patient outcome. Treatment with ICIs improves survival of patients with NSCLC, TNBC, and melanoma and BM; however, no significant improvement was observed in RCC. Investigations to identify prognostic features, oncogenomic profiles, and predictive biomarkers are warranted.
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: Patients receiving SRS versus whole brain RT and systemic therapy reported better posttreatment hrQoL. In addition, melanoma metastases, nonmarried, male, and older patients with reported better hrQoL in various as well as domains after intracranial RT.PMID:34392256 | DOI:10.1097/COC.0000000000000848
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
June 1, 2021 (RARITAN, N.J.) – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that more than 30 company-sponsored studies, including six oral presentations, will be featured during the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting, June 4-8. Janssen presentations will include new data and updates for both approved and investigational therapeutics that are being studied for the treatment of various solid tumors and blood cancers. Immediately following ASCO, additional data will be featured during the European Hematology Association (EHA) Virtual Congress, June 9-17. A c...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
ConclusionNew developments in targeted and immune-modulating therapies have postulated high intracranial efficacies in patients with BM from different solid tumors. However, more BM-specific studies and BM-specific endpoints in registration trials are warranted to underscore the role of systemic treatment in patients with BM.
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research
This study aimed to investigate the impact of receiving treatment at academic centers on the overall survival (OS) of cancer patients with brain metastases (BMs) regardless of the primary cancer site.METHODS: This retrospective analysis of the National Cancer Database (NCDB) included patients diagnosed with non-small cell lung cancer, small-cell lung cancer, other types of lung cancer, breast cancer, melanoma, colorectal cancer, and kidney cancer and had brain metastases at the time of diagnosis. The data were extracted from the de-identified file of the NCDB, a joint program of the Commission on Cancer of the American Col...
Source: Clinical Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
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