Editorial on Brain mets and ALK lung cancer

The Journal of Clinical Oncology has an editorial about the current research on treating brain mets for ALK+ patients that discusses ALK inhibitors and different kinds of radiation treatments.

Treatments discussed include: 1) Crizotinib, 2) Ceritinib 3) Alectinib 4) brigatinib, 5) PF-06463922, 6) whole brain radiation (WBR), 7) stereo static radiation (SRS), 8) radiation with memantine, and 9) radiation with hippocampal avoidance.

Conclusions and suggested research include: 1) avoiding WBR if there are 10 or less brain mets, 2) using ALK inhibitors that enter the brain as long as possible, 3) trials to test optimal combinations, timing, and sequencing of all these treatment options, 4) ALK + patients with brain mets that are treated with ALK inhibitors live notably longer than patients with brain mets seen in historical trials of lung cancer patients with brain mets and thus new recomended treatment protocols should be tested and tolerable side effects reevaluated, 5) about 30% of ALK + patients initially present with brain mets and up to 60% of patients treated with Crizotinib develop brain mets, and 6) both the use of memantine and the avoidance of the hippocampus appear to minimize the cognitive side effects of radiation treatment.


A related research paper is described below on October 22 under “ALK and brain mets”.

This entry was posted in alectinib - Alecensa from Chugai - Roche - GenenTech, Brain metastases, brigatinib-Alunbrig from Takeda, ceritinib - Zykadia from Novartis, crizotinib - Xalkori from Pfizer, Lung cancer, Potential Treatments, Research, Resistance to treatment, Side Effects. Bookmark the permalink.

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