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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2019
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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. |
format | Online Article Text |
id | pubmed-6378013 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
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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