Oh Yun, Stewart David J
Department of Thoracic, Head & Neck Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Oncology (Williston Park). 2008 Feb;22(2):168-78; discussion 178, 183, 188 passim.
Despite the high prevalence of brain metastases in patients with metastatic lung cancer, these patients have been excluded from enrollment in clinical trials of new therapeutic drugs. The reasons for exclusion have centered on concerns that the blood-brain barrier may impede drug delivery into brain metastases, that brain metastases confer a dismal survival for metastatic lung cancer patients, and that brain metastases carry risk for cerebrovascular hemorrhage. A focused, updated review of these issues, however, clearly shows that these particular concerns are unwarranted. An extensive review of clinical trials on the efficacy of chemotherapeutic agents against lung cancer brain metastases is also provided. This collective information describes an area in need of therapeutic development and supports an initiative to evaluate novel targeted therapies for lung cancer brain metastases.
尽管脑转移在转移性肺癌患者中普遍存在，但这些患者被排除在新治疗药物的临床试验入组之外。排除的原因主要集中在担心血脑屏障可能会阻碍药物进入脑转移灶、脑转移会使转移性肺癌患者的生存期不佳，以及脑转移存在脑血管出血风险。然而，对这些问题进行重点、更新的综述后清楚地表明，这些特定担忧是没有根据的。本文还对化疗药物治疗肺癌脑转移疗效的临床试验进行了广泛综述。这些综合信息描述了一个需要进行治疗开发的领域，并支持一项评估肺癌脑转移新型靶向治疗的倡议。
