Systemic Therapy for Lung Cancer Brain Metastases

2021 ◽  
Vol 22 (12) ◽  
Author(s):  
Alessia Pellerino ◽  
Francesco Bruno ◽  
Roberta Rudà ◽  
Riccardo Soffietti
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Systemic Therapy

The incidence and predictors of new brain metastases in patients with non–small cell lung cancer following discontinuation of systemic therapy

2021 ◽  
pp. 1-11
Author(s):  
Dennis London ◽  
Dev N. Patel ◽  
Bernadine Donahue ◽  
Ralph E. Navarro ◽  
Jason Gurewitz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Recurrent Events ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Small Cell ◽  
Small Cell Lung

OBJECTIVE Patients with non–small cell lung cancer (NSCLC) metastatic to the brain are living longer. The risk of new brain metastases when these patients stop systemic therapy is unknown. The authors hypothesized that the risk of new brain metastases remains constant for as long as patients are off systemic therapy. METHODS A prospectively collected registry of patients undergoing radiosurgery for brain metastases was analyzed. Of 606 patients with NSCLC, 63 met the inclusion criteria of discontinuing systemic therapy for at least 90 days and undergoing active surveillance. The risk factors for the development of new tumors were determined using Cox proportional hazards and recurrent events models. RESULTS The median duration to new brain metastases off systemic therapy was 16.0 months. The probability of developing an additional new tumor at 6, 12, and 18 months was 26%, 40%, and 53%, respectively. There were no additional new tumors 22 months after stopping therapy. Patients who discontinued therapy due to intolerance or progression of the disease and those with mutations in RAS or receptor tyrosine kinase (RTK) pathways (e.g., KRAS, EGFR) were more likely to develop new tumors (hazard ratio [HR] 2.25, 95% confidence interval [CI] 1.33–3.81, p = 2.5 × 10−3; HR 2.51, 95% CI 1.45–4.34, p = 9.8 × 10−4, respectively). CONCLUSIONS The rate of new brain metastases from NSCLC in patients off systemic therapy decreases over time and is uncommon 2 years after cessation of cancer therapy. Patients who stop therapy due to toxicity or who have RAS or RTK pathway mutations have a higher rate of new metastases and should be followed more closely.

Does Systemic Therapy Matter After Stereotactic Radiosurgery for Brain Metastases From Lung Cancer?

2014 ◽  
Vol 90 (1) ◽  
pp. S308
Author(s):  
S. Patel ◽  
W.F. Mourad ◽  
L. Patel ◽  
R. Young ◽  
R. Kabarriti ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Systemic Therapy

scholarly journals RADI-19. The Incidence of New Brain Metastases in Patients with Non-Small Cell Lung Cancer Following Discontinuation of Systemic Therapy

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii22-iii22
Author(s):  
Dennis London ◽  
Dev Patel ◽  
Bernadine Donahue ◽  
Ralph Navarro ◽  
Jason Gurewitz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Tyrosine Kinase ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Receptor Tyrosine Kinase ◽  
Systemic Therapy ◽  
Cox Regression ◽  
Small Cell ◽  
Small Cell Lung

Abstract Purpose Patients with non-small cell lung cancer (NSCLC) metastatic to the brain increasingly are living longer due to improvements in systemic therapy and local modalities. The risk of new brain metastases when these patients stop systemic therapy is unknown. Recognizing patterns of new tumor occurrence is necessary to determine the frequency of follow-up and the need for further treatment. Methods We included patients in a prospective registry who had non-small cell lung cancer (NSCLC) brain metastases, discontinued systemic therapy for at least 90 days, and underwent active surveillance. 63 patients with 73 off-periods were studied. The risk factors for the development of new tumors were determined using Cox regression and multi-state Markov modeling. Results The median time to new brain metastases off systemic therapy was 16.0 months. The probability of developing an additional new tumor at 6, 12, and 18 months was 26%, 40%, and 53%, respectively. There were no additional new tumors 22 months after stopping therapy. Patients who discontinued therapy due to intolerance or progression of the disease and those with mutations in RAS or receptor tyrosine kinase pathways (e.g. KRAS, EGFR) were more likely to develop new tumors (HR: 2.21, 95% CI: 1.25–3.91, p=6.3 x 10–3; HR: 2.03, 95% CI: 1.09–3.77, p=0.026, respectively). Conclusion The rate of new brain metastases from NSCLC in patients off systemic therapy decreases over time and is uncommon 2 years after cessation of cancer therapy. Patients who stop therapy due to toxicity or who have RAS or receptor tyrosine kinase pathway mutations have a higher rate of new metastases and should be followed more closely.

scholarly journals Targeted drugs for systemic therapy of lung cancer with brain metastases

Oncotarget ◽  
2017 ◽  
Vol 9 (4) ◽  
pp. 5459-5472 ◽  
Author(s):  
Ya-Wen Sun ◽  
Jian Xu ◽  
Jun Zhou ◽  
Wen-Juan Liu
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Systemic Therapy ◽  
Targeted Drugs

The role of post-SRS systemic therapy in synchronous lung cancer brain metastases.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e13052-e13052
Author(s):  
Shyamal Patel ◽  
Waleed Fouad Mourad ◽  
Rebekah L. Young ◽  
Rafi Kabarriti ◽  
Ravindra Yaparpalvi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Systemic Therapy ◽  
Synchronous Lung Cancer

scholarly journals Systemic therapy of brain metastases: non–small cell lung cancer, breast cancer, and melanoma

2016 ◽  
Vol 19 (1) ◽  
pp. i1-i24 ◽  
Author(s):  
Marc C. Chamberlain ◽  
Christina S. Baik ◽  
Vijayakrishna K. Gadi ◽  
Shailender Bhatia ◽  
Laura Q.M. Chow
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Systemic Therapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cancer Breast

Does Systemic Therapy Matter After Stereotactic Radiosurgery for Brain Metastases From Lung Cancer?

2014 ◽  
Vol 90 (5) ◽  
pp. S51-S52
Author(s):  
S. Patel ◽  
W.F. Mourad ◽  
L. Patel ◽  
R. Young ◽  
R. Kabarriti ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Systemic Therapy

scholarly journals Stereotactic radiosurgery in the era of novel systemic therapy for lung cancer brain metastases

2019 ◽  
Vol 2019 ◽  
Author(s):  
Sarah Mudra ◽  
Shruti Bhandari ◽  
Prashant Tripathi ◽  
Neal Dunlap ◽  
Goetz Kloecker
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Systemic Therapy

scholarly journals RT-27 * THE ROLE OF SYSTEMIC THERAPY AFTER STEREOTACTIC RADIOSURGERY FOR SYNCHRONOUS BRAIN METASTASES FROM LUNG CANCER

2014 ◽  
Vol 16 (suppl 5) ◽  
pp. v193-v193
Author(s):  
S. Patel ◽  
W. F. Mourad ◽  
R. Young ◽  
R. Kabarriti ◽  
R. Patel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Systemic Therapy

Systemic Therapy of Brain Metastases: Lung Cancer

2020 ◽  
pp. 207-217
Author(s):  
Adam Lauko ◽  
Vyshak Alva Venur ◽  
Manmeet S. Ahluwalia
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Systemic Therapy
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