Central nervous system metastases in advanced non-small cell lung cancer: A review of the therapeutic landscape
Journal Title
Cancer Treatment Reviews
Publication Type
Review
Abstract
Up to 40% of patients with non-small cell lung cancer (NSCLC) develop central nervous system (CNS) metastases. Current treatments for this subgroup of patients with advanced NSCLC include local therapies (surgery, stereotactic radiosurgery, and, less frequently, whole-brain radiotherapy), targeted therapies for oncogene-addicted NSCLC (small molecules, such as tyrosine kinase inhibitors, and antibody-drug conjugates), and immune checkpoint inhibitors (as monotherapy or combination therapy), with multiple new drugs in development. However, confirming the intracranial activity of these treatments has proven to be challenging, given that most lung cancer clinical trials exclude patients with untreated and/or progressing CNS metastases, or do not include prespecified CNS-related endpoints. Here we review progress in the treatment of patients with CNS metastases originating from NSCLC, examining local treatment options, systemic therapies, and multimodal therapeutic strategies. We also consider challenges regarding assessment of treatment response and provide thoughts around future directions for managing CNS disease in patients with advanced NSCLC.
Keywords
CNS metastases; Immune checkpoint inhibitors; Non-small cell lung cancer; Small molecules; Stereotactic radiosurgery; Tyrosine kinase inhibitors
Department(s)
Radiation Oncology
Open Access at Publisher's Site
https://doi.org/10.1016/j.ctrv.2024.102807
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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