Central nervous system metastases in advanced non-small cell lung cancer: A review of the therapeutic landscape

IF 11.3 1区化学 Q1 CHEMISTRY, PHYSICAL

ACS Catalysis Pub Date : 2024-08-02 DOI:10.1016/j.ctrv.2024.102807

Michael Weller , Jordi Remon , Stefan Rieken , Philipp Vollmuth , Myung-Ju Ahn , Giuseppe Minniti , Emilie Le Rhun , Manfred Westphal , Priscilla K. Brastianos , Ross A. Soo , John P. Kirkpatrick , Sarah B. Goldberg , Katarina Öhrling , Fiona Hegi-Johnson , Lizza E.L. Hendriks

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引用次数: 0

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.

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晚期非小细胞肺癌的中枢神经系统转移：治疗前景综述

多达 40% 的非小细胞肺癌（NSCLC）患者会发生中枢神经系统（CNS）转移。目前针对这一晚期 NSCLC 患者亚群的治疗方法包括局部疗法（手术、立体定向放射外科手术，以及较少见的全脑放疗）、针对癌基因成瘾 NSCLC 的靶向疗法（小分子药物，如酪氨酸激酶抑制剂和抗体药物共轭物）、免疫检查点抑制剂（作为单药或联合疗法），以及多种正在研发的新药。然而，由于大多数肺癌临床试验都排除了未经治疗和/或进展中的中枢神经系统转移患者，或不包括预先指定的中枢神经系统相关终点，因此证实这些治疗方法的颅内活性具有挑战性。在此，我们回顾了NSCLC中枢神经系统转移患者的治疗进展，探讨了局部治疗方案、系统疗法和多模式治疗策略。我们还考虑了治疗反应评估方面的挑战，并就晚期 NSCLC 患者中枢神经系统疾病的未来治疗方向提出了自己的看法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Catalysis CHEMISTRY, PHYSICAL-

CiteScore

20.80

自引率

6.20%

发文量

1253

审稿时长

1.5 months

期刊介绍： ACS Catalysis is an esteemed journal that publishes original research in the fields of heterogeneous catalysis, molecular catalysis, and biocatalysis. It offers broad coverage across diverse areas such as life sciences, organometallics and synthesis, photochemistry and electrochemistry, drug discovery and synthesis, materials science, environmental protection, polymer discovery and synthesis, and energy and fuels. The scope of the journal is to showcase innovative work in various aspects of catalysis. This includes new reactions and novel synthetic approaches utilizing known catalysts, the discovery or modification of new catalysts, elucidation of catalytic mechanisms through cutting-edge investigations, practical enhancements of existing processes, as well as conceptual advances in the field. Contributions to ACS Catalysis can encompass both experimental and theoretical research focused on catalytic molecules, macromolecules, and materials that exhibit catalytic turnover.