Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, Washington.
Division of Neuro-Oncology, Department of Neurology, University of Washington, Seattle, Washington.
J Thorac Oncol. 2015 Sep;10(9):1268-1278. doi: 10.1097/JTO.0000000000000615.
Approximately half of all patients with non-small-cell lung cancer (NSCLC) develop brain metastases (BM) during the course of their disease, leading to significant challenges in treatment. Molecular targeted tyrosine kinase inhibitors have proven effective for patients with activating mutations in the epidermal growth factor receptor gene and chromosomal rearrangements involving the anaplastic lymphoma kinase gene. Despite their efficacy in systemic disease control, their effectiveness in patients with BM is not well established. In this article, we review recent data on the use of epidermal growth factor receptor and anaplastic lymphoma kinase tyrosine kinase inhibitors for treatment of patients with NSCLC and BM. These data highlight the potential for meaningful disease control within the central nervous system and the inherent challenges in treating patients with NSCLC and BM.
大约一半的非小细胞肺癌(NSCLC)患者在疾病过程中会发展为脑转移(BM),这给治疗带来了重大挑战。分子靶向酪氨酸激酶抑制剂已被证明对表皮生长因子受体基因激活突变和涉及间变性淋巴瘤激酶基因染色体重排的患者有效。尽管它们在系统性疾病控制方面有效,但它们在 BM 患者中的有效性尚未得到充分证实。本文回顾了表皮生长因子受体和间变性淋巴瘤激酶酪氨酸激酶抑制剂在治疗 NSCLC 和 BM 患者中的最新数据。这些数据突出了在中枢神经系统内实现有意义的疾病控制的潜力,以及治疗 NSCLC 和 BM 患者所固有的挑战。