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Review
. 2018 Jun;25(Suppl 1):S103-S114.
doi: 10.3747/co.25.3733. Epub 2018 Jun 13.

Brain metastases in non-small-cell lung cancer: are tyrosine kinase inhibitors and checkpoint inhibitors now viable options?

S Morin-Ben Abdallah  1 , A Wong  1   2
Affiliations
Review

Brain metastases in non-small-cell lung cancer: are tyrosine kinase inhibitors and checkpoint inhibitors now viable options?

S Morin-Ben Abdallah et al. Curr Oncol. 2018 Jun.

Abstract

Significant progress has been made in the treatment of stage iv non-small-cell lung cancer (nsclc); however, the prognosis of patients with brain metastases remains poor. Resection and radiation therapy remain standard options. This issue is an important one because 10% of patients with nsclc have brain metastases at diagnosis, and 25%-40% develop brain metastases during their disease. Standard chemotherapy does not cross the blood-brain barrier. However, there is new hope that tyrosine kinase inhibitors (tkis) used in patients with identified targetable mutations such as mutations of EGFR and rearrangements of ALK could have activity in the central nervous system (cns). Furthermore, immunotherapy is increasingly becoming a standard option for patients with nsclc, and interest about the intracranial activity of those agents is growing. This review presents current data about the cns activity of the available major tkis and immunotherapy agents.

Keywords: ALK; EGFR; Non-small-cell lung cancer; afatinib; alectinib; ceritinib; crizotinib; epidermal growth factor receptor; immunotherapy; nivolumab; nsclc; osimertinib; pembrolizumab; tkis; tyrosine kinase inhibitors.

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References

    1. Detterbeck FC, Boffa DJ, Tanoue LT. The new lung cancer staging system. Chest. 2009;136:260–71. doi: 10.1378/chest.08-0978. - DOI - PubMed
    1. Goldstraw P, Chansky K, Crowley J, et al. on behalf of the International Association for the Study of Lung Cancer The iaslc lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11:39–51. doi: 10.1016/j.jtho.2015.09.009. - DOI - PubMed
    1. Eichler AF, Loeffler JS. Multidisciplinary management of brain metastases. Oncologist. 2007;12:884–98. doi: 10.1634/theoncologist.12-7-884. - DOI - PubMed
    1. Fan Y, Huang Z, Fang L, et al. Chemotherapy and egfr tyrosine kinase inhibitors for treatment of brain metastases from non-small-cell lung cancer: survival analysis in 210 patients. Onco Targets Ther. 2013;6:1789–803. - PMC - PubMed
    1. Hoffknecht P, Tufman A, Wehler T, et al. on behalf of the Afatinib Compassionate Use Consortium Efficacy of the irreversible ErbB family blocker afatinib in epidermal growth factor receptor (egfr) tyrosine kinase inhibitor (tki)–pretreated non-small-cell lung cancer patients with brain metastases or leptomeningeal disease. J Thorac Oncol. 2015;10:156–63. doi: 10.1097/JTO.0000000000000380. - DOI - PMC - PubMed

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