Targeted therapies for brain metastases – pro
To establish the current best practices, the American Society of Clinical Oncology recently provided clinical guidelines for the management of brain metastases from HER2-positive breast cancer, as reported by Ramakrishna and colleagues in the Journal of Clinical Oncology1 and reviewed in this issue of The ASCO Post. I also reviewed the guidelines from the National Comprehensive Cancer Network. There is increasing evidence, in non-small cell lung cancer that systemic therapy, including targeted therapy and immunotherapy, is effective against BM and the review by Ling and DeAngelis says that it may be an early choice, especially in patients with sensitive primary tumors. However, there are no guideleins in any disese and little evidence for Avastin for melanoma metastases.
References:
Naren Ramakrishnaet al, Recommendations on Disease Management for Patients With Advanced Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer and Brain Metastases: American Society of Clinical Oncology Clinical Practice Guideline JCO July 1, 2014 vol. 32 no. 192100-2108
Lin NU, Gelman RS, Younger J, et al: Phase II trial of carboplatin (C) and bevacizumab (BEV) in patients (pts) with breast cancer brain metastases (BCBM). J Clin Oncol 31(suppl):Abstract 513, 2013.
Xuling Lin and Lisa M. DeAngelis, Treatment of Brain Metastases JCO Oct 20, 2015:3475-3484;