[Molecular-Targeted Agents as a Novel Therapeutic Tool for Brain Metastases]

Area of Science:

• Oncology
• Neuro-oncology
• Genomics

Background:

• Brain metastases (BM) reflect primary cancer characteristics, necessitating genomic understanding for effective therapy.
• EGFR-TKI offers initial response for EGFR-mutated BM but limited duration and risk of leptomeningeal carcinomatosis (LMC).
• ALK-TKI demonstrates durable responses in ALK-positive BM, suggesting long-term treatment suitability.

Purpose of the Study:

• To evaluate the efficacy and safety of molecular-targeted agents for brain metastases.
• To understand the genomic drivers and progression patterns of BM.
• To optimize therapeutic strategies for improving patient survival and quality of life.

Main Methods:

• Analysis of patient data with brain metastases treated with EGFR-TKI and ALK-TKI.
• Review of genomic abnormalities associated with primary cancers and BM.
• Assessment of treatment response, progression patterns, and survival outcomes.

Main Results:

• EGFR-TKI provides significant but time-limited response in BM, with a tendency towards LMC progression.
• ALK-TKI shows prolonged response duration in ALK-positive BM, with a favorable long-term prognosis.
• Extracranial progression remains a primary cause of mortality, emphasizing the need for systemic treatment control.

Conclusions:

• Molecular-targeted agents are effective for BM, balancing safety and efficacy.
• Treatment strategies should prioritize long-term control and patient well-being.
• Genomic profiling is essential for tailoring therapies to individual brain metastases.