Venur Vyshak A, Ahluwalia Manmeet S
aDivision of Hematology and Oncology, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa bTaussig Cancer Institute, Cleveland Clinic cBurkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio, USA.
Curr Opin Oncol. 2017 Sep;29(5):395-399. doi: 10.1097/CCO.0000000000000393.
This review aims to highlight the novel therapeutic agents in the management of brain metastases which are in various stages of clinical development. We review the results from recent clinical trials, publications and presentations at recent national and international conferences.
Several new systemic treatment options for brain metastases are in early or advanced clinical trials. These drugs have good intracranial and extracranial activities. As lung cancer, breast cancer, and melanoma are the three most common causes of brain metastases, most agents in clinical development are focused on these tumor types. Several of these therapies are small molecule tyrosine kinase inhibitors or monoclonal antibodies against the tyrosine kinase receptors. Another exciting development in brain metastases management is the use of immunotherapy agents. The anti-CTLA-4 and\or anti-PD-1 antibodies have shown promising intracranial activity in melanoma and nonsmall cell lung cancer patients with brain metastases.
Contemporary clinical trials have shown encouraging intracranial activity of newer tyrosine kinase inhibitors, monoclonal antibodies against tyrosine kinase receptors and immunotherapy agents in select group of patients with brain metastases. Further studies are needed to develop therapeutic strategies, in order to improve survival in patients with brain metastases.
本综述旨在强调处于临床开发不同阶段的脑转移瘤治疗新型药物。我们回顾了近期临床试验结果、近期国内和国际会议上发表的文献及报告。
几种用于脑转移瘤的新型全身治疗方案正处于早期或晚期临床试验阶段。这些药物具有良好的颅内和颅外活性。由于肺癌、乳腺癌和黑色素瘤是脑转移瘤的三大最常见病因，目前临床开发中的大多数药物都集中于这些肿瘤类型。其中几种疗法是小分子酪氨酸激酶抑制剂或针对酪氨酸激酶受体的单克隆抗体。脑转移瘤治疗的另一个令人兴奋的进展是免疫治疗药物的使用。抗CTLA-4和/或抗PD-1抗体在患有脑转移瘤的黑色素瘤和非小细胞肺癌患者中已显示出有前景的颅内活性。
当代临床试验表明，在特定脑转移瘤患者群体中，新型酪氨酸激酶抑制剂、针对酪氨酸激酶受体的单克隆抗体和免疫治疗药物具有令人鼓舞的颅内活性。需要进一步研究以制定治疗策略，从而提高脑转移瘤患者的生存率。
