Indications and limitations of chemotherapy and targeted agents in non-small cell lung cancer brain metastases.
Lung cancer is characterized by the highest incidence of solid tumor-related brain metastases, which are reported with a growing incidence during the last decade. Prognostic assessment may help to identify subgroups of patients that could benefit from more aggressive therapy of metastatic disease, in particular when central nervous system is involved. The recent sub-classification of non-small cell lung cancer (NSCLC) into molecularly-defined "oncogene-addicted" tumors, the emergence of effective targeted treatments in molecularly defined patient subsets, global improvement of advanced NSCLC survival as well as the availability of refined new radiotherapy techniques are likely to impact on outcomes of patients with brain dissemination. The present review focuses on key evidence and research strategies for systemic treatment of patients with central nervous system involvement in non-small cell lung cancer.
Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: Stefan.Zimmermann@h-fr.ch.
Stefan
S
Zimmermann
Department of Oncology and Radiotherapy, Medical University of Gdansk, Poland. Electronic address: rafald@gumed.edu.pl.
Rafal
R
Dziadziuszko
Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: solange.peters@chuv.ch.
Solange
S
Peters
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001812:Blood-Brain Barrier; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D066246:ErbB Receptors / Q000187:drug effects / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000473:pathology*; D058990:Molecular Targeted Therapy / Q000379:methods; D011379:Prognosis; D011799:Quinazolines / Q000008:administration & dosage; D016634:Radiosurgery; D016896:Treatment Outcome
D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib
Brain metastasis; Driver oncogenes; Non small cell lung cancer (NSCLC); Stereotactic radiotherapy; Targeted treatment