Updates on Molecular Targeted Therapies for Intraparenchymal CNS Metastases

Central nervous system (CNS) metastases can occur in a high percentage of systemic cancer patients and is a major cause of morbidity and mortality in these patients. Almost any histology can find its way to the brain, but lung, breast, and melanoma are the most common pathologies seen in the CNS from metastatic disease. Identification of many key targets in the tumorigenesis pathway has been crucial to the development of a number of drugs that have demonstrated successful penetration of the blood–brain, blood–cerebrospinal fluid, and blood–tumor barriers. Targeted therapy and immunotherapy have dramatically revolutionized the field with treatment options that can provide successful and durable control of even CNS disease. In this review, we discuss major targets with successful treatment options as demonstrated in clinical trials. These include tyrosine kinase inhibitors, monoclonal antibodies, and antibody–drug conjugates. We also provide an update on the state of the field and highli..... READ ARTICLE

Cancers DOI:10.3390/cancers14010017

Authors: Akanksha Sharma, Lauren Singer, Priya Kumthekar

Review Paper, group1Kirk SmithDecember 21, 2021intraparenchymal metastases, CNS disease, metastatic disease, targeted therapy, immunotherapy, tyrosine kinase inhibitors, monoclonal antibodies

The Dandelion Dilemma Revisited for Oligoprogression: Treat the Whole Lawn or Weed Selectively?

When early-stage metastases appear, what is the evidence comparing the utility of systemic drug treatment versus focused radiation? "Oligoprogressive disease is a relatively new clinical concept describing progression at only a few sites of metastasis in patients with otherwise controlled widespread disease. Local ablative therapy for oligoprogressive disease may allow the continuation of systemic treatments by overcoming the few sub-clones that have developed resistance." READ ARTICLE

Clinical Oncology; DOI: 10.1016/j.clon.2019.05.015;

Authors: P.H. Patel, D. Palma, F. McDonald, A.C. Tree

Review PaperKirk SmithDecember 1, 2019metastatic disease, Oligometastases, oligoprogression, stereotactic body radiotherapy, targeted therapy