Systemic therapy of brain metastases: non-small cell lung cancer, breast cancer, and melanoma

Marc C Chamberlain; Christina S Baik; Vijayakrishna K Gadi; Shailender Bhatia; Laura Q M Chow

doi:10.1093/neuonc/now197

Systemic therapy of brain metastases: non-small cell lung cancer, breast cancer, and melanoma

Neuro Oncol. 2017 Jan;19(1):i1-i24. doi: 10.1093/neuonc/now197.

Authors

Marc C Chamberlain¹, Christina S Baik², Vijayakrishna K Gadi², Shailender Bhatia², Laura Q M Chow²

Affiliations

¹ Seattle Cancer Center Alliance, Seattle, Washington (M.C.C., C.S.B., V.K.G., S.B., L.Q.M.C.); Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington (C.S.B., V.K.G., L.Q.M.C.); Departments of Neurology and Neurological Surgery, University of Washington, Seattle, Washington (M.C.C.); Division of Medical Oncology, University of Washington, Seattle, Washington (C.S.B., V.K.G., S.B., L.Q.M.C) [email protected].
² Seattle Cancer Center Alliance, Seattle, Washington (M.C.C., C.S.B., V.K.G., S.B., L.Q.M.C.); Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington (C.S.B., V.K.G., L.Q.M.C.); Departments of Neurology and Neurological Surgery, University of Washington, Seattle, Washington (M.C.C.); Division of Medical Oncology, University of Washington, Seattle, Washington (C.S.B., V.K.G., S.B., L.Q.M.C).

Abstract

Brain metastases (BM) occur frequently in many cancers, particularly non-small cell lung cancer (NSCLC), breast cancer, and melanoma. The development of BM is associated with poor prognosis and has an adverse impact on survival and quality of life. Commonly used therapies for BM such as surgery or radiotherapy are associated with only modest benefits. However, recent advances in systemic therapy of many cancers have generated considerable interest in exploration of those therapies for treatment of intracranial metastases.This review discusses the epidemiology of BM from the aforementioned primary tumors and the challenges of using systemic therapies for metastatic disease located within the central nervous system. Cumulative data from several retrospective and small prospective studies suggest that molecularly targeted systemic therapies may be an effective option for the treatment of BM from NSCLC, breast cancer, and melanoma, either as monotherapy or in conjunction with other therapies. Larger prospective studies are warranted to further characterize the efficacy and safety profiles of these targeted agents for the treatment of BM.

Keywords: Brain metastases; blood-brain barrier; breast cancer; melanoma; non–small cell lung cancer.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Brain Neoplasms / secondary
Brain Neoplasms / therapy*
Breast Neoplasms / pathology
Breast Neoplasms / therapy*
Carcinoma, Non-Small-Cell Lung / pathology
Carcinoma, Non-Small-Cell Lung / therapy*
Female
Humans
Lung Neoplasms / pathology
Lung Neoplasms / therapy*
Melanoma / pathology
Melanoma / therapy*
Molecular Targeted Therapy