Zerebrale Metastasen: Herausforderungen der Systemtherapie

Am häufigsten tritt die Metastasierung ins zentrale Nervensystem bei Patienten mit Bronchialkarzinom, Melanom und Mammakarzinom auf [1]. Aufgrund der steigenden Lebenserwartung von Tumorpatienten, der verbesserten diagnostischen Sensitivität der Bildgebung und der anatomischen Besonderheiten des ZNS ist generell mit einer Zunahme der Inzidenz zu rechnen.

Schlüsselwörter

zerebrale Metastasen - Systemtherapie - zentrale Nervensystem

Publikationsverlauf

Artikel online veröffentlicht:
06. Mai 2022

• Literatur

• 1 Le Rhun E, Guckenberger M, Smits M. et al. EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours. Ann Oncol 2021; 32: 1332-1347
• 2 Byrne JD, Botticello T, Niemierko A. et al. Post-operative radiation therapy to the surgical cavity with standard fractionation in patients with brain metastases. Sci Rep 2020; 10: 6331
• 3 Brastianos PK, Carter SL, Santagata S. et al. Genomic Characterization of Brain Metastases Reveals Branched Evolution and Potential Therapeutic Targets. Cancer Discov 2015; 5: 1164-1177
• 4 An N, Jing W, Wang H. et al. Risk factors for brain metastases in patients with non-small-cell lung cancer. Cancer Med 2018; 7: 6357-6364
• 5 Barlesi F, Gervais R, Lena H. et al. Pemetrexed and cisplatin as first-line chemotherapy for advanced non-small-cell lung cancer (NSCLC) with asymptomatic inoperable brain metastases: a multicenter phase II trial (GFPC 07–01). Ann Oncol 2011; 22: 2466-2470
• 6 Gadgeel S, Rodriguez-Abreu D, Speranza G. et al. Updated Analysis From KEYNOTE-189: Pembrolizumab or Placebo Plus Pemetrexed and Platinum for Previously Untreated Metastatic Nonsquamous Non-Small-Cell Lung Cancer. J Clin Oncol 2020; 38: 1505-1517
• 7 Reck M, Rodríguez-Abreu D, Robinson AG. et al. Five-Year Outcomes With Pembrolizumab Versus Chemotherapy for Metastatic Non–Small-Cell Lung Cancer With PD-L1 Tumor Proportion Score ≥ 50%. J Clin Oncol 2021; 39: 2339-2349
• 8 Gadgeel S, Peters S, Mok T. et al. Alectinib versus crizotinib in treatment-naive anaplastic lymphoma kinase-positive (ALK+) non-small-cell lung cancer: CNS efficacy results from the ALEX study. Ann Oncol 2018; 29: 2214-2222
• 9 Camidge DR, Kim HR, Ahn MJ. et al. Brigatinib Versus Crizotinib in Advanced ALK Inhibitor-Naive ALK-Positive Non-Small Cell Lung Cancer: Second Interim Analysis of the Phase III ALTA-1L Trial. J Clin Oncol 2020; 38: 3592-3603
• 10 Reungwetwattana T, Nakagawa K, Cho BC. et al. CNS Response to Osimertinib Versus Standard Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients With Untreated EGFR-Mutated Advanced Non-Small-Cell Lung Cancer. J Clin Oncol 2018;
• 11 Slotman B, Faivre-Finn C, Kramer G. et al. Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med 2007; 357: 664-672
• 12 Takahashi T, Yamanaka T, Seto T. et al. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial. The Lancet Oncology 2017; 18: 663-671
• 13 Chen G, Huynh M, Chen A. et al. Chemotherapy for brain metastases in small-cell lung cancer. Clin Lung Cancer 2008; 9: 35-38
• 14 Goldman JW, Dvorkin M, Chen Y. et al. Durvalumab, with or without tremelimumab, plus platinum–etoposide versus platinum–etoposide alone in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): updated results from a randomised, controlled, open-label, phase 3 trial. The Lancet Oncology 2021; 22: 51-65
• 15 Gutzmer R, Vordermark D, Hassel JC. et al. Melanoma brain metastases – Interdisciplinary management recommendations 2020. Cancer Treat Rev 2020; 89: 102083
• 16 Goldberg SB, Gettinger SN, Mahajan A. et al. Pembrolizumab for patients with melanoma or non-small-cell lung cancer and untreated brain metastases: early analysis of a non-randomised, open-label, phase 2 trial. The Lancet Oncology 2016; 17: 976-983
• 17 Long GV, Atkinson V, Lo S. et al. Combination nivolumab and ipilimumab or nivolumab alone in melanoma brain metastases: a multicentre randomised phase 2 study. Lancet Oncol 2018; 19: 672-681
• 18 Di Giacomo AM, Chiarion-Sileni V, Del Vecchio M. et al. Primary Analysis and 4-Year Follow-Up of the Phase III NIBIT-M2 Trial in Melanoma Patients With Brain Metastases. Clin Cancer Res 2021; 27: 4737-4745
• 19 Dimitriou F, Zaremba A, Allayous C. et al. Sustainable responses in metastatic melanoma patients with and without brain metastases after elective discontinuation of anti-PD1-based immunotherapy due to complete response. Eur J Cancer 2021; 149: 37-48
• 20 Tawbi HA, Forsyth PA, Hodi FS. et al. Safety and efficacy of the combination of nivolumab plus ipilimumab in patients with melanoma and asymptomatic or symptomatic brain metastases (CheckMate 204). Neuro Oncol 2021; 23: 1961-1973
• 21 Long GV, Trefzer U, Davies MA. et al. Dabrafenib in patients with Val600Glu or Val600Lys BRAF-mutant melanoma metastatic to the brain (BREAK-MB): a multicentre, open-label, phase 2 trial. The Lancet Oncology 2012; 13: 1087-1095
• 22 Davies MA, Saiag P, Robert C. et al. Dabrafenib plus trametinib in patients with BRAFV600-mutant melanoma brain metastases (COMBI-MB): a multicentre, multicohort, open-label, phase 2 trial. The Lancet Oncology 2017; 18: 863-873
• 23 Drago JZ, Lawrence D, Livingstone E. et al. Clinical experience with combination BRAF/MEK inhibitors for melanoma with brain metastases: a real-life multicenter study. Melanoma Res 2019; 29: 65-69
• 24 Holbrook K, Lutzky J, Davies MA. et al. Intracranial antitumor activity with encorafenib plus binimetinib in patients with melanoma brain metastases: A case series. Cancer 2020; 126: 523-530
• 25 Shewade A, Hsieh AF-C, Mani A. et al. Real-world (RW) characteristics, treatment (tx) patterns, and overall survival (OS) in US patients (pts) with metastatic breast cancer (mBC) and CNS metastases (CNS mets). J Clin Oncol 2018; 36: 1037-1037
• 26 Brufsky AM, Mayer M, Rugo HS. et al. Central nervous system metastases in patients with HER2-positive metastatic breast cancer: incidence, treatment, and survival in patients from registHER. Clin Cancer Res 2011; 17: 4834-4843
• 27 Montemurro F, Delaloge S, Barrios CH. et al. Trastuzumab emtansine (T-DM1) in patients with HER2-positive metastatic breast cancer and brain metastases: exploratory final analysis of cohort 1 from KAMILLA, a single-arm phase IIIb clinical trial. Ann Oncol 2020; 31: 1350-1358
• 28 Bachelot T, Romieu G, Campone M. et al. Lapatinib plus capecitabine in patients with previously untreated brain metastases from HER2-positive metastatic breast cancer (LANDSCAPE): a single-group phase 2 study. The Lancet Oncology 2013; 14: 64-71
• 29 Saura C, Oliveira M, Feng YH. et al. Neratinib Plus Capecitabine Versus Lapatinib Plus Capecitabine in HER2-Positive Metastatic Breast Cancer Previously Treated With >/= 2 HER2-Directed Regimens: Phase III NALA Trial. J Clin Oncol 2020; 38: 3138-3149