Lung cancer brain metastases management at the dawn of personalized medicine: are we ready to break the barriers?

IF 65.4 1区医学 Q1 ONCOLOGY

Annals of Oncology Pub Date : 2026-04-28 DOI:10.1016/j.annonc.2026.04.014

A Mavrikios, M Bortolot, C Le Péchoux, J Remon, A Botticella, M Aldea, P D Brown, C G Rusthoven, P Lavaud, M Frelaut, P Abdayem, D Lavigne, A Camps-Malea, B Besse, D Planchard, F Barlesi, J Jacob, P Gougis, S Knafo, C Chargari, F Dhermain, E Deutsch, C Faivre-Finn, A Levy

{"title":"Lung cancer brain metastases management at the dawn of personalized medicine: are we ready to break the barriers?","authors":"A Mavrikios, M Bortolot, C Le Péchoux, J Remon, A Botticella, M Aldea, P D Brown, C G Rusthoven, P Lavaud, M Frelaut, P Abdayem, D Lavigne, A Camps-Malea, B Besse, D Planchard, F Barlesi, J Jacob, P Gougis, S Knafo, C Chargari, F Dhermain, E Deutsch, C Faivre-Finn, A Levy","doi":"10.1016/j.annonc.2026.04.014","DOIUrl":null,"url":null,"abstract":"<p><p>Brain metastases (BM) occur in nearly half of patients with lung cancer and significantly impair survival and quality of life. Historically, limited blood-brain barrier penetration and low intracranial efficacy of systemic therapies restricted treatment options. However, advances in immune checkpoint inhibitors and next-generation CNS-penetrant targeted therapies have reshaped the therapeutic landscape, improving intracranial control and patient outcomes. In parallel, stereotactic radiotherapy has emerged as a precise and effective local treatment with a more favorable safety profile compared with whole-brain radiotherapy. The integration of systemic and local approaches, guided by personalized medicine, offers new opportunities to optimize central nervous system disease control. Nevertheless, these advances raise key challenges regarding treatment sequencing, patient selection, and risk-adapted strategies. This review summarizes the evolving management of lung cancer BM and highlights future directions for clinical trial design, emphasizing the integration of clinical, biological, and radiological tools to guide individualized treatment strategies.</p>","PeriodicalId":8000,"journal":{"name":"Annals of Oncology","volume":" ","pages":""},"PeriodicalIF":65.4000,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.annonc.2026.04.014","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Brain metastases (BM) occur in nearly half of patients with lung cancer and significantly impair survival and quality of life. Historically, limited blood-brain barrier penetration and low intracranial efficacy of systemic therapies restricted treatment options. However, advances in immune checkpoint inhibitors and next-generation CNS-penetrant targeted therapies have reshaped the therapeutic landscape, improving intracranial control and patient outcomes. In parallel, stereotactic radiotherapy has emerged as a precise and effective local treatment with a more favorable safety profile compared with whole-brain radiotherapy. The integration of systemic and local approaches, guided by personalized medicine, offers new opportunities to optimize central nervous system disease control. Nevertheless, these advances raise key challenges regarding treatment sequencing, patient selection, and risk-adapted strategies. This review summarizes the evolving management of lung cancer BM and highlights future directions for clinical trial design, emphasizing the integration of clinical, biological, and radiological tools to guide individualized treatment strategies.

查看原文本刊更多论文

个性化医疗曙光下的肺癌脑转移管理：我们准备好打破障碍了吗？

脑转移（BM）发生在近一半的肺癌患者中，严重影响生存和生活质量。历史上，有限的血脑屏障穿透和低颅内疗效的全身治疗限制了治疗的选择。然而，免疫检查点抑制剂和下一代cns渗透靶向治疗的进展已经重塑了治疗前景，改善了颅内控制和患者预后。与此同时，与全脑放疗相比，立体定向放疗已成为一种精确有效的局部治疗方法，具有更有利的安全性。在个性化医疗的指导下，系统和局部方法的整合为优化中枢神经系统疾病控制提供了新的机会。然而，这些进展提出了治疗顺序、患者选择和风险适应策略方面的关键挑战。本文综述了肺癌脑转移治疗的发展，并强调了临床试验设计的未来方向，强调临床、生物学和放射学工具的整合，以指导个体化治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Annals of Oncology 医学-肿瘤学

CiteScore

63.90

自引率

1.00%

发文量

3712

审稿时长

2-3 weeks

期刊介绍： Annals of Oncology, the official journal of the European Society for Medical Oncology and the Japanese Society of Medical Oncology, offers rapid and efficient peer-reviewed publications on innovative cancer treatments and translational research in oncology and precision medicine. The journal primarily focuses on areas such as systemic anticancer therapy, with a specific emphasis on molecular targeted agents and new immune therapies. We also welcome randomized trials, including negative results, as well as top-level guidelines. Additionally, we encourage submissions in emerging fields that are crucial to personalized medicine, such as molecular pathology, bioinformatics, modern statistics, and biotechnologies. Manuscripts related to radiotherapy, surgery, and pediatrics will be considered if they demonstrate a clear interaction with any of the aforementioned fields or if they present groundbreaking findings. Our international editorial board comprises renowned experts who are leaders in their respective fields. Through Annals of Oncology, we strive to provide the most effective communication on the dynamic and ever-evolving global oncology landscape.