Lung Cancer with Brain Metastasis—Treatment Strategies and Molecular Characteristics DOI Open Access
S. Wang,

Matan Uriel,

Haiying Cheng

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7371 - 7371

Published: Dec. 3, 2024

Lung cancer is a leading cause of brain metastases (BMs), with 10-20% patients non-small cell lung (NSCLC) presenting BMs at diagnosis and 25-50% developing them over the course their disease. Historically, have posed significant therapeutic challenges, partly due to blood barrier (BBB), which restricts drug penetration central nervous system. Consequently, were initially managed local treatments, including surgical resection, stereotactic radiosurgery, whole radiation therapy. In recent years, however, systemic treatments for advanced significantly, particularly development molecularly-targeted therapies immunotherapies. The discovery driver mutations novel tyrosine kinase inhibitors (TKIs) yielded encouraging intracranial responses in NSCLC actionable genetic alterations (e.g.,

Language: Английский

Immunotherapy and the Tumor Microenvironment in Brain Metastases from Non-Small Cell Lung Cancer: Challenges and Future Directions DOI Creative Commons

Meng Wang,

Jihua Yang, S. Wang

et al.

Current Oncology, Journal Year: 2025, Volume and Issue: 32(3), P. 171 - 171

Published: March 16, 2025

Brain metastases (BMs) are a relatively common and severe complication in advanced non-small cell lung cancer (NSCLC), significantly affecting patient prognosis. Metastatic tumor cells can alter the brain microenvironment (TME) to promote an immunosuppressive state, characterized by reduced infiltration of tumor-infiltrating lymphocytes (TILs), diminished expression programmed death-ligand 1 (PD-L1), changes other proinflammatory factors immune populations. Microglia, resident macrophages brain, play pivotal role modulating central nervous system (CNS) through interactions with metastatic cells, astrocytes, infiltrating T cells. The M2 phenotype microglia contributes immunosuppression BM via activation signaling pathways such as STAT3 PI3K-AKT-mTOR. Recent advances have enhanced our understanding landscape BMs NSCLC, particularly regarding evasion within CNS. Current immunotherapeutic strategies, including checkpoint inhibitors, shown promise for NSCLC patients BM, demonstrating intracranial activity manageable safety profiles. Future research is warranted further explore molecular mechanisms underlying aiming develop more effective treatments.

Language: Английский

Citations

0
Immunotherapy in lung cancer brain metastases DOI Creative Commons
Eunice Paisana, Rita Cascão,

Magda Alvoeiro

et al.

npj Precision Oncology, Journal Year: 2025, Volume and Issue: 9(1)

Published: May 6, 2025

Brain metastases (BM) occur frequently in lung cancer, particularly non-small cell cancer (NSCLC) patients and remain a significant cause of morbidity mortality. Standard therapies have limited efficacy due to poor crossing the blood-brain barrier distinct features between BM primary tumor. This review explores immune landscape brain metastatic disease, emerging immunotherapeutic strategies, promising biomarkers NSCLC patients.

Language: Английский

Citations

0
Efficacy and safety of combining anti-angiogenic therapy, radiotherapy, and PD-1 inhibitors in patients with driver gene-negative non-small cell lung cancer brain metastases: a retrospective study DOI Creative Commons
Xianwen Zhang, Qian Sun, Rujun Chen

et al.

BMC Cancer, Journal Year: 2024, Volume and Issue: 24(1)

Published: Dec. 3, 2024

The efficacy and safety of anti-angiogenic combination therapy in patients with driver gene-negative non-small cell lung cancer (NSCLC) brain metastases (BM) are uncertain. Eighty-eight records NSCLC treated craniocerebral radiotherapy (RT) programmed death factor-1 (PD-1) inhibitors between May 2021 2023 were collected. Based on whether (AT) is combined or not, categorized into the AT group non (NAT) group. NAT received RT PD-1 inhibitor those ≥ 4 cycles AT. Comparing clinical these two patient cohorts was main goal study. By 1, 2024, iORR 94.0% 63.2% for group, respectively. 1- 2-year iLPFS 93.6%, 80.9% 69.7%, 36.4%, iDPFS 86.7%, 56.3% 59.1%, 48.3%, OS 82.0%, 36.6% 68.4%, 34.6%, Compared to standard treatment (RT inhibitors), addition prolonged median (NR vs. 22.0 months, hazard ratio [HR] = 11.004, P < 0.001) 20.0 HR 8.732, 0.003), but not significant extension (21.0 19.0 1.601, 0.206). Multivariable analysis showed that significantly associated (HR 4.233, 0.002) 2.824, 0.007), whereas only GPA score improved 0.589, 0.019). incidence hypertension an increasing trend, no increased risk radiation-induced necrosis found. No drug-related intracranial hemorrhage events occurred. Combining AT, RT, can substantially improve BM; however, it better OS.

Language: Английский

Citations

1
Lung Cancer with Brain Metastasis—Treatment Strategies and Molecular Characteristics DOI Open Access
S. Wang,

Matan Uriel,

Haiying Cheng

et al.

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(23), P. 7371 - 7371

Published: Dec. 3, 2024

Lung cancer is a leading cause of brain metastases (BMs), with 10-20% patients non-small cell lung (NSCLC) presenting BMs at diagnosis and 25-50% developing them over the course their disease. Historically, have posed significant therapeutic challenges, partly due to blood barrier (BBB), which restricts drug penetration central nervous system. Consequently, were initially managed local treatments, including surgical resection, stereotactic radiosurgery, whole radiation therapy. In recent years, however, systemic treatments for advanced significantly, particularly development molecularly-targeted therapies immunotherapies. The discovery driver mutations novel tyrosine kinase inhibitors (TKIs) yielded encouraging intracranial responses in NSCLC actionable genetic alterations (e.g.,

Language: Английский

Citations

1