title: Novel Treatment Strategies for Brain Metastases in Non-small-cell Lung Cancer.
abstract: Brain metastases are common in patients with non-small cell lung cancer (NSCLC), and due to associated poor prognosis, this field is an important area of need for the development of innovative medical therapies. Therapies including local approaches through surgical intervention and/or radiation and evolving systemic therapies have led to improvements in the treatment of brain metastases in patients with lung cancer. Strategies that consider applying advanced radiation techniques to minimize toxicity, intervening early with effective systemic therapies to spare radiation/surgery, testing radiosensitization combinations, and developing drug penetrant molecules have and will continue to define new practice patterns. We believe that in carefully considered asymptomatic patients, first-line systemic therapy may be considered before radiation therapy and small-molecule targeted therapy may provide an opportunity to defer radiation therapy for recurrence or progression of disease. The next several years in oncology drug development will see the reporting on of brain penetrant molecules in oncogene-defined non-small cell lung cancer. Ongoing studies will evaluate immunotherapies in patients with brain metastases with associated endpoints. We hope that continued drug development and carefully designed clinical trials may afford an opportunity to improve the lives of patients with brain metastases.
authors.affiliation: Division of Hematology and Oncology, University of California, San Diego School of Medicine, UCSD Moores Cancer Center, San Diego, CA, USA.
authors.forename: Nam
authors.initials: N
authors.lastname: Bui
authors.affiliation: Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, San Diego, CA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Woodward
authors.affiliation: Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, San Diego, CA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Johnson
authors.affiliation: Division of Hematology and Oncology, University of California, San Diego School of Medicine, UCSD Moores Cancer Center, San Diego, CA, USA. hhusain@ucsd.edu.|Center for Personalized Cancer Therapy, UCSD Moores Cancer Center, San Diego, CA, USA. hhusain@ucsd.edu.|, 3855 Health Sciences Dr. #0987, La Jolla, CA, 92093, USA. hhusain@ucsd.edu.
authors.forename: Hatim
authors.initials: H
authors.lastname: Husain
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001812:Blood-Brain Barrier; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000556:secondary / Q000628:therapy*; D006801:Humans; D007167:Immunotherapy; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents
keywords: Blood-brain barrier; Brain metastases; Chemotherapy; Immunotherapy; Lung cancer; Radiation; Targeted therapy