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From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC

Non-small cell lung cancer patients with brain metastases have a multitude of treatment options, but there is currently no international and multidisciplinary consensus concerning their optimal treatment. Local therapies have the principal role, especially in symptomatic patients. Advances in surger...

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Autores principales: Protopapa, Maria, Kouloulias, Vassilis, Nikoloudi, Styliani, Papadimitriou, Christos, Gogalis, Giannis, Zygogianni, Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378013/
https://www.ncbi.nlm.nih.gov/pubmed/30853981
http://dx.doi.org/10.1155/2019/3267409
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author Protopapa, Maria
Kouloulias, Vassilis
Nikoloudi, Styliani
Papadimitriou, Christos
Gogalis, Giannis
Zygogianni, Anna
author_facet Protopapa, Maria
Kouloulias, Vassilis
Nikoloudi, Styliani
Papadimitriou, Christos
Gogalis, Giannis
Zygogianni, Anna
author_sort Protopapa, Maria
collection PubMed
description Non-small cell lung cancer patients with brain metastases have a multitude of treatment options, but there is currently no international and multidisciplinary consensus concerning their optimal treatment. Local therapies have the principal role, especially in symptomatic patients. Advances in surgery and radiation therapy manage considerable local control. Systemic treatments have shown effect in clinical trials and in real life clinical settings; yet, at present, this is restricted to patients with asymptomatic or stable intracranial lesions. Targeted agents can have a benefit only in patients with EGFR mutations or ALK rearrangement. Immunotherapy has shown impressive results in patients with PD-L1 expression in tumor cells. Its effects can be further enhanced by a synergy with radiotherapy, possibly by increasing the percentage of responders. The present review summarizes the need for more effective systemic treatments, so that the increased intracranial control achieved by local treatments can be translated in an increase in overall survival.
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spelling pubmed-63780132019-03-10 From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC Protopapa, Maria Kouloulias, Vassilis Nikoloudi, Styliani Papadimitriou, Christos Gogalis, Giannis Zygogianni, Anna J Oncol Review Article Non-small cell lung cancer patients with brain metastases have a multitude of treatment options, but there is currently no international and multidisciplinary consensus concerning their optimal treatment. Local therapies have the principal role, especially in symptomatic patients. Advances in surgery and radiation therapy manage considerable local control. Systemic treatments have shown effect in clinical trials and in real life clinical settings; yet, at present, this is restricted to patients with asymptomatic or stable intracranial lesions. Targeted agents can have a benefit only in patients with EGFR mutations or ALK rearrangement. Immunotherapy has shown impressive results in patients with PD-L1 expression in tumor cells. Its effects can be further enhanced by a synergy with radiotherapy, possibly by increasing the percentage of responders. The present review summarizes the need for more effective systemic treatments, so that the increased intracranial control achieved by local treatments can be translated in an increase in overall survival. Hindawi 2019-02-03 /pmc/articles/PMC6378013/ /pubmed/30853981 http://dx.doi.org/10.1155/2019/3267409 Text en Copyright © 2019 Maria Protopapa et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Protopapa, Maria
Kouloulias, Vassilis
Nikoloudi, Styliani
Papadimitriou, Christos
Gogalis, Giannis
Zygogianni, Anna
From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC
title From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC
title_full From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC
title_fullStr From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC
title_full_unstemmed From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC
title_short From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC
title_sort from whole-brain radiotherapy to immunotherapy: a multidisciplinary approach for patients with brain metastases from nsclc
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378013/
https://www.ncbi.nlm.nih.gov/pubmed/30853981
http://dx.doi.org/10.1155/2019/3267409
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