title: [Brain metastases of non small cell lung cancers: systemic treatments].
abstract: Chemotherapy, as all systemic treatments, is generally effective in brain metastases because the brain blood barrier (BBB) does not affect treatment's diffusion. Platinum-based chemotherapy provides response rates ranging from 23 to 50% for brain metastases. Anti-EGFR therapies are effective mostly when a somatic EGFR activating mutation is detected, or in selected population (adenocarcinoma, Asian population, never-smokers and women): response rate ranges from 38 to 69.6%. Bevacizumab is now allowed for non-small cell lung cancer (NSCLC) patients with brain metastases and non-squamous histology. The presence of untreated brain metastases may not influence its efficacy combined with paclitaxel-carboplatin. The best sequence for multimodality management of brain metastases has to be established but upfront systemic treatments in patients with asymptomatic brain metastases is a valid option.
authors: Institut Gustave-Roussy, Département de Médecine Oncologique, 114, rue Édouard-Vaillant, 94800 Villejuif, France.
authors: Marie
authors: M
authors: Chaubet-Houdu
authors: Benjamin
authors: B
authors: Besse
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000556:secondary*; D002945:Cisplatin / Q000627:therapeutic use; D000077547:Crizotinib; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms; D011720:Pyrazoles / Q000627:therapeutic use; D011725:Pyridines / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D011720:Pyrazoles; D011725:Pyridines; D011799:Quinazolines; D000068258:Bevacizumab; D000077547:Crizotinib; D066246:ErbB Receptors; D002945:Cisplatin; D000077156:Gefitinib
keywords: EGFR; antiangiogenic agents; brain metastases; chemotherapy; non-small cell lung cancer