Treatment decisions for patients with NSCLC metastasized to the brain should involve a multidisciplinary team, considering factors such as immunotherapy efficacy and optimal treatment sequences.
Treatment decisions about the care of patients with non–small cell lung cancer that has metastasized to the brain should always be made by a multidisciplinary team, according to a lung cancer research specialist.
"Also, we don't know the best sequence of treatments, and we really need more preclinical research regarding the tumor microenvironment in the CNS," she said. At the time of extracranial progressive disease, should the treatment be another immumotherapy, chemotherapy, or a targeted agent?For cases such as that described by Dr. Hendriks the question is whether upfront local therapy is needed if the patient is initially asymptomatic. Other considerations concerning early local therapy include the risks for late toxicities and whether there is also extracranial disease that needs to be controlled.
European Society of Medical Oncology guidelines recommend that asymptomatic patients or those with oligosymptomatic NSCLC brain metastases with an oncogenic driver receive a brain-penetrating TKI. Those with no oncogenic drive but high PD-1 expression should receive upfront immunotherapy alone, while those with PD-1 ligand 1 expression below 50% receive chemoimmunotherapy.recommends a CNS-penetrating TKI for patients with asymptomatic NSCLC brain metastases bearing EGFR or ALK alterations.
KRAS-positive NSCLC is associated with a high risk for brain metastases, and these metastases share the same mutation as the primary cancer, suggesting potential efficacy of KRAS G12c inhibitors. There is preclinical evidence that has CNS penetration, and there was evidence for intracranial efficacy of the drug in the KRYSTAL-1b trial, Dr. Hendriks noted.
South Africa Latest News, South Africa Headlines
Similar News:You can also read news stories similar to this one that we have collected from other news sources.
Sauk Village man alleging discrimination sues, village, police officer and gas stationScott Angel was denied the ability to order his usual iced coffee through a Dunkin’ drive-through Feb. 9, receiving a written note saying “You are Not served here” from an employee, according to th…
Read more »
Russell Wilson sells Cherry Hills Village mansion for $21.5M, takes multimillion-dollar lossFormer Denver Broncos quarterback sold his Colorado home Wednesday for $3.5 million less than its purchase price in 2022
Read more »
Russell Wilson sells Cherry Hills Village mansion for $21.5M, takes multimillion-dollar lossThe most expensive home ever sold in the Denver area is officially off the market — and Russell Wilson took a $3.5 million loss to seal the deal.
Read more »
No Benefit to Adding Chemo to Immunotherapy in Older Adults With NSCLCAdding chemotherapy to immunotherapy increased the adverse event burden without improving survival outcomes compared with immunotherapy alone in older adults with NSCLC.
Read more »
Amivantamab Offers Post-Progression Benefit in EGFRm NSCLCEven if patients with EGFR-mutated lung cancer progress on amivantamab plus chemotherapy, there is a survival benefit over chemotherapy alone, follow-up analyses of PAPILLON and MARIPOSA-2 showed.
Read more »
Does Neoadjuvant Chemoimmunotherapy Boost Survival in NSCLC?A meta-analysis confirms that neoadjuvant chemoimmunotherapy improves survival outcomes in most patients with resectable NSCLC, except for overall survival in patients with baseline PD-L1 below 1%.
Read more »