Lung cancer represents the most common cause of brain dissemination. Oncogene-addicted (EGFR- and ALK-positive) non-small cell lung cancers (NSCLCs) are characterized by a unique metastatic neurotropism resulting in a particularly high incidence of brain metastases. The goal of optimal brain metastases management is to improve both overall survival and quality of life, with the focus on neurocognitive function preservation.
Neurosurgery is offered to patients presenting with limited intracranial tumor burden located in surgically accessible un-eloquent regions of the brain, whereas stereotactic radiosurgery represents the preferred radiotherapy option for patients not amenable to surgery. Whole brain radiotherapy, owing to its neurocognitive sequelae, should be reserved for patients with multiple lesions.
EGFR and ALK tyrosine kinase inhibitors (TKIs) provide significantly superior systemic response rates and progression-free survival compared to standard chemotherapy in the molecularl..... READ ARTICLE
Cancer Treatment Reviews DOI:10.1016/j.ctrv.2018.10.011
Authors: Anna Wrona, Rafał Dziadziuszko, Jacek Jassem
Radiosurgery for multiple BMs is controversial, yet patients with EGFR-mutated and ALK-rearranged NSCLC may be uniquely suited to benefit from this approach. These results support single and multiple courses of radiosurgery without WBRT for patients with oncogene-addicted NSCLC with four or more BMs. READ ARTICLE
Journal of Thoracic Oncology DOI:10.1016/j.jtho.2017.12.006
Authors: Tyler P. Robin, Ross Camidge, Kelly Stuhr, Sameer K. Nath, Robert E. Breeze, Jose M. Pacheco, Arthur K. Liu, Laurie E. Gaspar, Thomas Purcell, Robert C. Doebele, Brian D. Kavanagh and Chad G. Rusthoven