Systemic Therapy for Melanoma: ASCO Guideline Update

Journal of Clinical Oncology, Journal Year: 2023, Volume and Issue: 41(30), P. 4794 - 4820

Published: Aug. 14, 2023

To provide guidance to clinicians regarding the use of systemic therapy for melanoma.American Society Clinical Oncology convened an Expert Panel and conducted updated systematic review literature.The identified 21 additional randomized trials.Neoadjuvant pembrolizumab was newly recommended patients with resectable stage IIIB IV cutaneous melanoma. For resected melanoma, adjuvant nivolumab or IIB-C disease plus ipilimumab added as a potential option disease. unresectable metastatic relatlimab regardless BRAF mutation status followed by preferred over BRAF/MEK inhibitor therapy. Talimogene laherparepvec is no longer wild-type who have progressed on anti-PD-1 Ipilimumab- ipilimumab-containing regimens are BRAF-mutated after progression other therapies.This full update incorporates new recommendations uveal melanoma published in 2022 Rapid Recommendation Update.Additional information available at www.asco.org/melanoma-guidelines.

Language: Английский

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Treatment of Oligometastatic Non-Small Cell Lung Cancer: An ASTRO/ESTRO Clinical Practice Guideline

Practical Radiation Oncology, Journal Year: 2023, Volume and Issue: 13(5), P. 393 - 412

Published: April 25, 2023

Language: Английский

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The dilemma of radiation necrosis from diagnosis to treatment in the management of brain metastases

Neuro-Oncology, Journal Year: 2024, Volume and Issue: 26(Supplement_1), P. S56 - S65

Published: March 1, 2024

Abstract Radiation therapy with stereotactic radiosurgery (SRS) or whole brain radiation is a mainstay of treatment for patients metastases. The use SRS in the management metastases becoming increasingly common and provides excellent local control. Cerebral necrosis (RN) late complication that can be seen months to years following often indistinguishable from tumor progression on conventional imaging. In this review article, we explore risk factors associated development necrosis, advanced imaging modalities used aid diagnosis, potential strategies manage side effects.

Language: Английский

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National Cancer Institute Collaborative Workshop on Shaping the Landscape of Brain Metastases Research: challenges and recommended priorities

The Lancet Oncology, Journal Year: 2023, Volume and Issue: 24(8), P. e344 - e354

Published: Aug. 1, 2023

Language: Английский

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Sustained Preservation of Cognition and Prevention of Patient-Reported Symptoms With Hippocampal Avoidance During Whole-Brain Radiation Therapy for Brain Metastases: Final Results of NRG Oncology CC001

International Journal of Radiation Oncology*Biology*Physics, Journal Year: 2023, Volume and Issue: 117(3), P. 571 - 580

Published: May 6, 2023

Language: Английский

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Stereotactic radiosurgery versus whole-brain radiotherapy in patients with 4–10 brain metastases: A nonrandomized controlled trial

Radiotherapy and Oncology, Journal Year: 2023, Volume and Issue: 186, P. 109744 - 109744

Published: June 15, 2023

Background and PurposeThere is no randomized evidence comparing whole-brain radiotherapy (WBRT) stereotactic radiosurgery (SRS) in the treatment of multiple brain metastases. This prospective nonrandomized controlled single arm trial attempts to reduce gap until results are available.Material MethodsWe included patients with 4-10 metastases ECOG performance status ≤2 from all histologies except small-cell lung cancer, germ cell tumors, lymphoma. The retrospective WBRT-cohort was selected 2:1 consecutive treated within 2012-2017. Propensity-score matching performed adjust for confounding factors such as sex, age, primary tumor histology, dsGPA score, systemic therapy. SRS using a LINAC-based single-isocenter technique employing prescription doses 15-20Gyx1 at 80% isodose line. historical control consisted equivalent WBRT dose regimens either 3Gyx10 or 2.5Gyx14.ResultsPatients were recruited 2017–2020, end follow-up July 1st, 2021. 40 SRS-cohort 70 eligible controls WBRT-cohort. Median OS, iPFS 10.4months (95%-CI 9.3-NA) 7.1months 3.9-14.2) SRS-cohort, 6.5months 4.9-10.4), 5.9months 4.1-8.8) WBRT-cohort, respectively. Differences non-significant OS (HR: 0.65; 95%-CI 0.40-1.05; P=.074) (P=.28). No grade III toxicities observed SRS-cohort.ConclusionThis did not meet its endpoint OS-improvement compared thus superiority could be proven. Prospective trials era immunotherapy targeted therapies warranted.

Language: Английский

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Impact of concurrent antibody–drug conjugates and radiotherapy on symptomatic radiation necrosis in breast cancer patients with brain metastases: a multicenter retrospective study

Journal of Neuro-Oncology, Journal Year: 2024, Volume and Issue: 168(3), P. 415 - 423

Published: April 22, 2024

Language: Английский

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Stereotactic Radiosurgery and Stereotactic Fractionated Radiotherapy in the Management of Brain Metastases

Cancers, Journal Year: 2024, Volume and Issue: 16(6), P. 1093 - 1093

Published: March 8, 2024

The management of brain metastases (BM) remains an important and complex issue in the treatment cancer-related neurological complications. BM are particularly common patients diagnosed with lung, melanoma, or breast cancer. Over past decade, therapeutic approaches for majority have changed. Considering addressing fact that living longer, need to provide effective local control while preserving quality life neurocognition is fundamental. SRS SRT become a more commonly chosen option BM. Despite significant advances BM, numerous questions remain regarding patient selection optimal sequencing. Clinical trials critical advancing our understanding especially as alternatives available. Therefore, it imperative interdisciplinary teams improve their latest SRS-SRT. This review aims comprehensively explore treatments covering clinical considerations application (e.g., eligibility), managing limited multiple intact brainstem metastases, exploring combination therapies systemic treatments, considering health economic perspective.

Language: Английский

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European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment - Update 2024

European Journal of Cancer, Journal Year: 2024, Volume and Issue: 215, P. 115153 - 115153

Published: Nov. 29, 2024

Language: Английский

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Effects of Differences in the Increment Parameter Controlling Sector Numbers on Volumetric-Modulated Arc-Based Radiosurgery Planning With the Monaco® System for Single Brain Metastases

Cureus, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 12, 2025

Purpose A volumetric-modulated arcs (VMAs) technique, including non-coplanar arcs, enables efficient generation and implementation of suitable dose distribution in linac-based stereotactic radiosurgery (SRS) using a multileaf collimator (MLC) for brain metastases (BMs). In Monaco® treatment planning system (TPS) (Elekta AB, Stockholm, Sweden), an increment (Inc) parameter controls the number sectors each arc VMA optimization. However, optimal Inc setting has remained to be determined. This study, therefore, aimed investigate impacts differences on VMA-based SRS BMs. Materials methods study targeted 30 clinical BMs with gross tumor volume (GTV) 0.08-48.09 cc (median 9.81 cc), which were previously analyzed. The platform included 5 mm leaf-width MLC Agility® Sweden) TPS AB). prescribed was uniformly assigned GTV near-minimum (DV-0.01 minimum minus 0.01 cc, i.e., D>95% >0.20 D95% ≤0.20 minimize uncovered equivalent 3 diameter lesion. optimized prioritize conformity steepness gradient outside GTV, without constraints within boundary, according established methods. settings 10º, 20º, 30º (Inc 10, 20, 30) compared, all other parameters unified. Results significantly inferior gradients both inside gradual attenuation margin surface. 10 had most inhomogeneous highest increase (2-4 mm) boundary longest total calculation time (tCT). 20 shortest tCT showed tendency superior concentric lamellarity 2 2-4 boundary. There no significant difference between except superiority gradients. Conclusions process quality 20º per is recommended templating terms overall plan reasonable tCT. 10º can option if it necessary further enhance although increases considerably.

Language: Английский

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