Molecular Profiling of the Cerebrospinal Fluid in Leptomeningeal NSCLC: The Shape of Things to Come?

Tsui, David Chun Cheong; Camidge, D. Ross

doi:10.1016/j.jtho.2020.11.016

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…A dual inhibitor of EGFR and HER2, Neratinib may be helpful in patients with select EGFR mutations [ 80 ]. Studies to analyze tumor DNA in CSF may help explore CNS progression after the previous intracranial response [ 81 ]. ALK targeting therapies such as alectinib, ceritinib, lorlatinib, and brigatinib have demonstrated high intracranial disease control rates [ 65 , 82 – 91 ].…”

Section: Treatmentmentioning

confidence: 99%

Update on the Management of Brain Metastasis

et al. 2022

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Brain metastases occur in almost one-third of adult patients with solid tumor malignancies and lead to considerable patient morbidity and mortality. The rising incidence of brain metastases has been ascribed to the development of better imaging and screening techniques and the formulation of better systemic therapies. Until recently, the multimodal management of brain metastases focused primarily on the utilization of neurosurgical techniques, with varying combinations of whole-brain radiation therapy and stereotactic radio-surgical procedures. Over the past 2 decades, in particular, the increment in knowledge pertaining to molecular genetics and the pathogenesis of brain metastases has led to significant developments in targeted therapies and immunotherapies. This review article highlights the recent updates in the management of brain metastases with an emphasis on novel systemic therapies.

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Section: Treatmentmentioning

confidence: 99%

Update on the Management of Brain Metastasis

et al. 2022

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“…At present, several ongoing clinical trials are investigating the use of ICIs with or without chemotherapy as neoadjuvant therapy in resectable NSCLC ( Table 3 .). Several previous early-phase (phases I & II) had shown that ICIs with or without chemotherapy were feasible and effective as a neoadjuvant therapy before surgery [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 ]. Therefore, four main phase III clinical trials (KEYNOTE 617, CheckMate 816, IMpower 030, AEGEAN) are conducted and ongoing now.…”

Section: Neoadjuvant and Adjuvant Immunotherapy In Surgically Resectable Nsclcmentioning

confidence: 99%

“…MPR was the endpoint employed most frequently in early-phase trials with neoadjuvant ICIs [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 ]. For early-stage NSCLC, the treatment goal should focus on disease cure and prolonging survival.…”

Section: Future Perspectives: the Challenges Of Immunotherapy In Surgically Resectable Nsclcmentioning

confidence: 99%

“…In the design of clinical trials with neoadjuvant ICIs, the neoadjuvant therapies were administrated for 2–4 cycles [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. These studies reported that the radiological response assessed by Response Evaluation Criteria in Solid Tumors (RECIST) did not correlate with pathological response [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. For example, Forde et al showed that 90% of patients with pathological response in the study ...…”

Section: Future Perspectives: the Challenges Of Immunotherapy In Surgically Resectable Nsclcmentioning

confidence: 99%

“…Regarding the HPD of ICIs treatment, NSCLC patients with risk factors may be considered surgery directly followed by adjuvant therapy. Fortunately, no unexpected immune-related adverse event (irAE) that lead to the delay of surgery was reported in these trials with neoadjuvant ICIs in early-stage NSCLC [ 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. In an early trial of neoadjuvant therapy with the combination of nivolumab and ipilimumab in melanoma, 18 of 20 study patients (90%) experienced grade 3 and 4 irAE, and cessation of therapy was required in most patients (17 of 18) [ 141 ].…”

Section: Future Perspectives: the Challenges Of Immunotherapy In Surgically Resectable Nsclcmentioning

confidence: 99%

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Immunotherapy and Vaccination in Surgically Resectable Non-Small Cell Lung Cancer (NSCLC)

Chiu

Lin

et al. 2021

Vaccines

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Early-stage NSCLC (stages I and II, and some IIIA diseases) accounts for approximately 30% of non-small cell lung cancer (NSCLC) cases, with surgery being its main treatment modality. The risk of disease recurrence and cancer-related death, however, remains high among NSCLC patients after complete surgical resection. In previous studies on the long-term follow-up of post-operative NSCLC, the results showed that the five-year survival rate was about 65% for stage IB and about 35% for stage IIIA diseases. Platinum-based chemotherapy with or without radiation therapy has been used as a neoadjuvant therapy or post-operative adjuvant therapy in NSCLC, but the improvement of survival is limited. Immune checkpoint inhibitors (ICIs) have effectively improved the 5-year survival of advanced NSCLC patients. Cancer vaccination has also been explored and used in the prevention of cancer or reducing disease recurrence in resected NSCLC. Here, we review studies that have focused on the use of immunotherapies (i.e., ICIs and vaccination) in surgically resectable NSCLC. We present the results of completed clinical trials that have used ICIs as neoadjuvant therapies in pre-operative NSCLC. Ongoing clinical trials investigating ICIs as neoadjuvant and adjuvant therapies are also summarized.

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