Complex treatment of lung cancer patients with brain metastases


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Abstract

Long-term results of complex treatment of lung cancer (LC) patients with brain métastases (BM), consisted of the removal of metastatic tumors were studied, factors influencing the survival of these patients were studied, and the effectiveness of targeted therapy was evaluated. The study included 129 LC patients with BM, who underwent microsurgical removal of the intracerebral foci. The tactics of further treatment were determined on the basis of somatic status, prevalence of the process, histological and molecular-genetic type of tumor. The median overall survival of patients was 12.4 months, the median disease-free survival was 11.0 months. Overall survival was significantly dependent on the RPA class, the histological nature of the tumor, the degree of radicality of the removed distant metastatic tumor, the presence of extracranial foci, the volume and type of the post-operative treatment. It was concluded that surgical treatment of solitary BM in LC improves the quality of life of patients and creates conditions for their further treatment. All patients with non-squamous cell carcinoma require the determination of EGFR or ALK mutations. The targeted therapy of patients with mutated EGFR increases the median overall survival rate by almost 2 times.

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About the authors

A. M Zaitsev

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

P. V Datsenko

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

A. B Ryabov

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

O. V Pikin

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

G. S Alekseeva

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

S. A Kisarev

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

T. M Kobyletskaya

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

O. N Kirsanova

Moscow Scientific Research Oncological Institute n.a. P.A. Herzen - a Branch of the FSBI “National Medical Research Radiological Center" of RMH

Email: o.n.kirsanova@gmail.com
Junior Researcher at the Department of Neurosurgery

References

  1. Jemal A., Bray F., Center M.M., Ferlay J., Ward E., Forman D. Global cancer statistics. CA Cancer J. Clin. 2011;61(2):69-90.
  2. Herbst R.S., Heymach J.V., Lippman S.M. Lung cancer. N Engl J Med 2008;359:1367-80.
  3. Hubbs J.L., Boyd J.A., Hollis D., Chino J.P., Saynak M., Kelsey C.R. Factors associated with the development of brain metastases: analysis of 975 patients with early stage nonsmall cell lung cancer. Cancer. 2010;116(21):5038-46.
  4. Li C., Fang R., Sun Y., Han X., Li F., Gao B., lafrate A.J., Liu X.Y., Pao W., Chen H., Ji H. Spectrum of oncogenic driver mutations in lung adenocarcinomas from East Asian never smokers. PLoS One. 2011; 6:e28204.
  5. Gaspar L., Scott C., Rotman M., Asbell S., Phillips T., Wasserman T., McKenna W.G., Byhardt R. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy. Oncology Group (RTOG) brain metastases trials. Int. J. Radiat. Oncol. Biol. Phys. 1997; 37:745-51.
  6. Gerber N.K., Yamada Y., Rimner A., Shi W., Riely G.J., Beal K., Yu H.A., Chan T.A., Zhang Z., Wu A.J. Erlotinib versus radiation therapy for brain metastases in patients with EGFR-mutant lung adenocarcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2014;89:322-29.
  7. Magnuson W.J., Guillod P.D., Gettinger S.N., Gettinger S.N., Yu J.B., Chiang V.L. Impact of deferring radiation therapy in patients with epidermal growth factor receptor-mutant nonsmall cell lung cancer who develop brain metastases. Int. J. Radiat. Oncol. Biol. Phys. 2016;95:673-79.
  8. Iuchi T., Shingyoji M., Sakaida T., Hatano K., Nagano O., Itakura M., Kageyama H., Yokoi S., Hasegawa Y., Kawasaki K., lizasa T. Phase II trial of gefitinib alone without radiation therapy for Japanese patients with brain metastases from EGFR mutant lung adenocarcinoma. Lung Cancer. 2013;82:282-87.
  9. Park S.J., Kim H.T., Lee D.H., Kim K.P., Kim S.W., Suh C., Lee J.S. Efficacy of epidermal growth factor receptor tyrosine kinase inhibitors for brain metastasis in non-small cell lung cancer patients harboring either exon 19 or 21 mutation. Lung Cancer. 2012;77:556-60.
  10. Rosell R., Carcereny E., Gervais R., Vergnenegre A., Massuti B., Felip E., et al; Spanish Lung Cancer Group in collaboration with Groupe Français de Pneumo-Cancérologie and Associazione Italiana Oncologia Toracica. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutationpositive non-small-cell lung cancer (EURTAC): A multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012;13:239-46.
  11. Heon S., Yeap B.Y., Lindeman N.I., Joshi V.A., Butaney M., Britt G.J., Costa D.B., Rabin M.S., Jackman D.M., Johnson B.E. The impact of initial gefitinib or erlotinib versus chemotherapy on central nervous system progression in advanced non-small cell lung cancer with EGFR mutations. Clin. Cancer. Res. 2012;18:4406-41.
  12. Baek M.Y., Ahn H.K., Park K.R., Park H.S., Kang S.M., Park I., Kim Y.S., Hong J., Sym S.J., Park J., Lee J.H., Shin D.B., Cho E.K. Epidermal growth factor receptor mutation and pattern of brain metastasis in patients with non-small cell lung cancer. Korean J. Intern. Med. 2016 Apr 20.
  13. Shin D.Y., Na I.I., Kim C.H., Park S., Baek H., Yang S.H. EGFR mutation and brain metastasis in pulmonary adenocarcinomas. J. Thorac. Oncol. 2014;9:195-99.
  14. Stapleton S.L., Reid J.M., Thompson P.A., Ames M.M., McGovern R.M., McGuffey L., Nuchtern J., Dauser R., Blaney S.M. Plasma and cerebrospinal fluid pharmacokinetics of pemetrexed after intravenous administration in non-human primates. Cancer Chemother. Pharmacol. 2007;59:461-66.
  15. Moro-Sibilot D., Smit E., de Castro Carpeho J., Lesniewski-Kmak K., Aerts J.G., Villatoro R., Kraaij K., Nacerddine K., Dyachkova Y., Smith K.T., Girvan A., Visseren-Grul C., Schnabel P.A. Non-small cell lung cancer patients with brain metastases treated with first-line platinum-doublet chemotherapy: Analysis from the European FRAME study. Lung Cancer. 2015;90:427-32.
  16. Togashi Y., Masago K., Fukudo M., Terada T., Fujita S., Irisa K., Sakamori Y., Kim Y.H., Mio T., Inui K., Mishima M. Cerebrospinal fluid concentration of erlotinib and its active metabolite OSI-420 in patients with central nervous system metastases of non-small cell lung cancer. J. Thorac. Oncol. 2010;5:950-55.
  17. Park S.Y., Kim Y.M., Pyo H. Gefitinib radiosensitizes non-small cell lung cancer cells through inhibition of ataxia telangiectasia mutated. Mol. Cancer. 2010;9:222.
  18. van Vulpen M., Kal H.B., Taphoorn M.J., El-Sharouni S.Y. Changes in blood-brain barrier permeability induced by radiotherapy: implications for timing of chemotherapy? (Review). Oncol. Rep. 2002;9(4):683-88.
  19. Lu Y., Fan Y. Combined action of EGFR tyrosine kinase inhibitors and whole-brain radiotherapy on EGFRmutated non-small-cell lung cancer patients with brain metastasis. Onco. Targets Ther. 2016;9:1135-43.

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