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The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
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Continued versus Interrupted Targeted Therapy during Metastasis-Directed Stereotactic Radiotherapy: A Retrospective

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Stereotactic radiotherapy (SRT) combined with targeted therapy (TT) in metastatic cancer patients showed no significant difference in overall survival or progression-free survival whether TT was interrupted or not. Severe toxicity was rare, but continuous use of certain targeted therapies with SRT warrants further investigation.

Keywords:
BRAF inhibitorsconcurrentmetastasis-directed radiotherapystereotactictargeted therapytyrosine kinase inhibitors

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Oncology

Background:

  • Targeted therapy (TT) improves outcomes in metastatic cancers.
  • Stereotactic radiotherapy (SRT) is increasingly used with TT to control resistant metastases and delay disease progression.

Purpose of the Study:

  • To evaluate the safety and efficacy of combining SRT with TT in metastatic cancer patients.
  • To assess the impact of continuous versus interrupted TT during metastasis-directed SRT.

Main Methods:

  • Analysis of 454 SRTs in 158 patients from the international TOaSTT database.
  • Patients received SRT with concurrent TT (within 30 days).
  • Kaplan-Meier and log rank testing were used; toxicity assessed by CTCAE v4.03 criteria.

Main Results:

  • One-year overall survival (OS), progression-free survival (PFS), and local control (LC) were 59%, 24%, and 84%, respectively.
  • No significant difference in OS or PFS was observed between continuous and interrupted TT during SRT.
  • Any-grade toxicity was significantly increased with continuous EGFR inhibitors or BRAF/MEK inhibitors during SRT (p=0.016 and p=0.009, respectively).

Conclusions:

  • Combining SRT with continuous or interrupted TT did not impact OS or PFS in metastatic cancer patients.
  • Severe toxicity associated with combined SRT and TT was infrequent.
  • Increased toxicity observed with continuous EGFR inhibitors or BRAF(±MEK) inhibitors during SRT warrants further study.