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Brain Metastases from Lung Tumors

  • Andrew Dhawan
  • Manmeet AhluwaliaEmail author
Chapter

Abstract

Lung cancer is the most common primary cancer to metastasize to the brain, and brain metastases in this group of patients are responsible for an increasing burden of disease. Divided into two broad histologic categories, non-small-cell (NSCLC) and small-cell lung cancers (SCLC), brain metastases affect both groups of patients. Among patients with SCLC, a more aggressive disease course is thought to be responsible for 10% of patients having brain metastases on presentation, with an increasing incidence owing to improved CNS imaging. Among patients with NSCLC, the time course of the disease presentation is varied, and 10–30% of patients will have brain metastases during their disease course, with an increasing incidence largely due to more effective primary tumor control. The treatment landscape for primary and metastatic lung cancer is rapidly evolving, with improved understanding of the molecular alterations driving these tumors and targeted therapies against these molecular alterations becoming approved for clinical use. In addition, immunotherapies in the form of checkpoint inhibitors have shown significant promise in treating lung cancer and metastatic disease and, for certain subsets of patients, are first-line therapy. In this chapter, we focus on the developing and evolving role of these therapies and review associated evidence for the treatment of brain metastases from lung cancers.

Keywords

Non-small-cell lung cancer Small-cell lung cancer NSCLC SCLC Checkpoint inhibitor EGFR ALK BRAF RET MET RET1 KRAS HER2 

Notes

Acknowledgements

Disclosures: AD: None. MSA: Grant—Institutional grant from Novartis, Novocure, Astrazeneca, Abbvie, BMS, Pharmacyclics, Incyte, Merck, Bayer, Mimivax, Boston Biomedical

Consultant: Prime Education, Prime Oncology, Elsevier, Monteris AstraZeneca, Bristol-Myers Squibb, Abbvie, CBT Pharmaceuticals, Kadmon, VBI Vaccines, Flatiron Health, Varian Medical Systems, Karyopharm Therapeutics

Stocks: Mimivax, Doctible

Royalties: Wiley

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Cleveland Clinic FoundationClevelandUSA
  2. 2.Burkhardt Brain Tumor and Neuro-Oncology Center, Neurological Institute, Cleveland ClinicClevelandUSA

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