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Systemic therapy of brain metastases

Presented By
Dr Natasha Leighl, Dr Edrune Arriola Aperribay
Conference
ELCC 2019
Trial
Phase 3, FLAURA, ALEX, ALTA-1L, AURA3
Systemic therapies may provide a prolonged control of CNS metastases potentially delaying use of radiotherapy in some cases. Newer agents might provide a longer protection and control. Chemotherapy and checkpoint inhibition in PD-L1-positive disease have activity in non-oncogene-addicted lung cancer, but outcomes are not (yet) as dramatic as with TKIs in oncogene-addicted tumours with CNS metastasis. This offers a unique opportunity to select patients for systemic therapy of this ‘sanctuary site’. In decision-making, consultation within the multidisciplinary team is essential. “We really need a team approach”, Dr Natasha Leighl (Princess Margaret Cancer Centre, Toronto, Canada) emphasised. Sequencing systemic therapy without driver mutations In non-oncogene-addicted NSCLC, the management of CNS metastases is harder compared with the treatment of oncogene-addicted lung cancer. Dr Leighl mentioned some key questions: Should we st...


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