Brain metastases(BMs)are the most common cause of intracranial neoplasms in adults with poor prognosis.Most BMs originate from lung cancer,breast cancer,or melanoma.Radiotherapy(RT),including whole brain radiotherapy(...Brain metastases(BMs)are the most common cause of intracranial neoplasms in adults with poor prognosis.Most BMs originate from lung cancer,breast cancer,or melanoma.Radiotherapy(RT),including whole brain radiotherapy(WBRT)and stereotactic radiation surgery(SRS),has been widely explored and is considered a mainstay anticancer treatment for BMs.Over the past decade,the advent of novel systemic therapies has revolutionized the treatment of BMs.In this context,there is a strong rationale for using a combination of treatments based on RT,with the aim of achieving both local disease control and extracranial disease control.This review focuses on describing the latest progress in RT as well as the synergistic effects of the optimal combinations of RT and systemic treatment modalities for BMs,to provide perspectives on current treatments.展开更多
Recurrence is a major concern for adult patients with glioblastomas(GBMs), and the prognosis remains poor.Although several therapies have been assessed, most of them have not achieved satisfactory results. Therefore, ...Recurrence is a major concern for adult patients with glioblastomas(GBMs), and the prognosis remains poor.Although several therapies have been assessed, most of them have not achieved satisfactory results. Therefore, there is currently no standard treatment for adult recurrent GBM(r GBM). Here, we review the results of clinical trials for the systematic therapy of r GBM. Regorafenib, rindopepimut and neoadjuvant programmed death 1(PD-1)inhibitors are promising agents for r GBM, while regorafenib is effective in both O6-methylguanine DNA methyltransferase(MGMT) promoter methylated and unmethylated patients. Temozolomide rechallenge and alkylating agents combined with bevacizumab can be useful for patients with MGMT methylation, and patients with isocitrate dehydrogenase(IDH) mutations or second recurrence can benefit from vocimagene amiretrorepvec(Toca511). Some phase I trials on targeted therapy and immunotherapy have shown positive results, and results from further studies are expected. In addition to the analysis of existing clinical trial results, forthcoming trials should be well designed, and patients are encouraged to participate in appropriate clinical trials.展开更多
基金supported by grants from Beijing Municipal Natural Science Foundation(Grant No.7202150)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Grant No.2016-I2M-2-001)。
文摘Brain metastases(BMs)are the most common cause of intracranial neoplasms in adults with poor prognosis.Most BMs originate from lung cancer,breast cancer,or melanoma.Radiotherapy(RT),including whole brain radiotherapy(WBRT)and stereotactic radiation surgery(SRS),has been widely explored and is considered a mainstay anticancer treatment for BMs.Over the past decade,the advent of novel systemic therapies has revolutionized the treatment of BMs.In this context,there is a strong rationale for using a combination of treatments based on RT,with the aim of achieving both local disease control and extracranial disease control.This review focuses on describing the latest progress in RT as well as the synergistic effects of the optimal combinations of RT and systemic treatment modalities for BMs,to provide perspectives on current treatments.
基金supported by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (No. 2016-I2M2-001)the Beijing Municipal Natural Science Foundation [No. 7202150 and 19JCZDJC 64200(Z)]the Tsinghua University-Peking Union Medical College Hospital Initiative Scientific Research Program (No. 2019ZLH101)。
文摘Recurrence is a major concern for adult patients with glioblastomas(GBMs), and the prognosis remains poor.Although several therapies have been assessed, most of them have not achieved satisfactory results. Therefore, there is currently no standard treatment for adult recurrent GBM(r GBM). Here, we review the results of clinical trials for the systematic therapy of r GBM. Regorafenib, rindopepimut and neoadjuvant programmed death 1(PD-1)inhibitors are promising agents for r GBM, while regorafenib is effective in both O6-methylguanine DNA methyltransferase(MGMT) promoter methylated and unmethylated patients. Temozolomide rechallenge and alkylating agents combined with bevacizumab can be useful for patients with MGMT methylation, and patients with isocitrate dehydrogenase(IDH) mutations or second recurrence can benefit from vocimagene amiretrorepvec(Toca511). Some phase I trials on targeted therapy and immunotherapy have shown positive results, and results from further studies are expected. In addition to the analysis of existing clinical trial results, forthcoming trials should be well designed, and patients are encouraged to participate in appropriate clinical trials.
