Les métastases cérébrales et les méningites carcinomateuses des cancers bronchiques

Abstract

Brain metastases and leptomeningeal metastases are severe and frequent complications of lung cancer, particularly in patients with EGFR mutations or ALK rearrangements. BM affect up to 80% of patients with small-cell lung cancer and 50% of those with non-smallcell lung cancer Stereotactic radiotherapy is the current gold standard for BM management, while whole-brain radiotherapy remains indicated in cases of multiple or diffuse lesions. Next-generation tyrosine kinase inhibitors, such as osimertinib and lorlatinib, have shown significant intracranial efficacy. LM diagnosis relies on MRI and cerebrospinal fluid analysis, with notable advances through next-generation sequencing that identifies mutations and resistance mechanisms. Treatment of LM remains complex. Clinical trials remain scarce for this population, highlighting an urgent need for dedicated research. Optimal integration of local and systemic therapies remains a major challenge in managing BM and LM in BC.