MET-8 EFFECT OF VEGF-TARGETED THERAPY FOR SYMPTOMATIC/REFRACTORY BRAIN EDEMA CAUSED BY METASTATIC BRAIN TUMORS

BACKGROUND: Molecular target therapy with EGFR and ALK inhibitors greatly improved the prognosis of lung cancer patients with driver mutation-positive metastatic brain tumors. Inhibitors of VEGF are also useful for treating brain edema induced by brain metastases. In this study, we examined the impact of VEGF inhibitors on symptomatic/refractory edema in metastatic brain tumors. MATERIALS AND METHODS: This retrospective study included the patients with metastatic brain tumors who received VEGF-targeted therapy for symptomatic/refractory brain edema. The primary cancer site, radiation therapy for metastatic brain tumors, corticosteroid administration, symptoms, Karnofsky performance status, and MR imagings before and after VEGF-targeted therapy were all gathered from the patient's medical records. RESULTS: 19 patients with symptomatic/refractory cerebral edema [NSCLC(15), LCNEC(1), SCLC(1), breast cancer(2), colorectal cancer (2)] were treated with anti-VEGF medication. Nine patients were treated with bevacizumab as a monotherapy, and 12 patients were treated with bevacizumab or ramucirumab in combination as a multi-drug therapy. Prior brain irradiation was administered to 17 patients. Corticosteroids were used to treat brain edema in 8 patients. VEGF inhibitors were effective in all patients, improving symptoms by reducing brain edema. CONCLUSION: We recommend VEGF inhibitor for symptomatic/refractory edema of metastatic brain tumors. This treatment may be successful independent of the primary cancer site.