Motexafin gadolinium injection for the treatment of brain metastases in patients with non-small cell lung cancer

Abstract

Despite recent advances in technology, targeting, and chemotherapy, brain metastasis from non-small cell lung cancer (NSCLC) remains a significant problem. The vast majority of patients with this diagnosis undergo whole brain radiation therapy (WBRT). However, outcomes are still quite poor with median survivals measured in only months. In an effort to enhance outcomes from external beam radiation treatments, radiosensitizers have been investigated. Motexafin gadolinium (MGd) (Xcytrin, Sunnyvale, CA, USA) is a novel radiation sensitizer with a unique mechanism of action that may increase the therapeutic index of WBRT for patients with brain metastases, particularly in those with NSCLC histologies. Here we review the rationale for the use of this drug as well as its current and future role as a radiation enhancer in the management of NSCLC brain metastasis.

Figure 1

Chemical structure of motexafin gadolinium.

Figure 2

Before and after 10 doses of motexafin gadolinium (MGd). MRI scans; both are non-contrast MR images. Selective uptake in the brain metastases is clearly evident (courtesy of Minesh P Mehta, University of Wisconsin).