Skip to main content
Erschienen in:

17.05.2024 | ZNS-Metastasen | Zertifizierte Fortbildung

Neuroonkologie

Interdisziplinäre Behandlungsstrategien bei Hirnmetastasen*

verfasst von: PD Dr. med. Pia Zeiner, Prof. Dr. med. Claus Rödel, Prof. Dr. med. Marcus Czabanka, Prof. Dr. med. Joachim Steinbach

Erschienen in: InFo Hämatologie + Onkologie | Ausgabe 5/2024

zum CME-Kurs Einloggen, um Zugang zu erhalten

Auszug

Hirnmetastasen sind die häufigsten Hirntumoren im Erwachsenenalter. Die Standardtherapie umfasst neurochirurgische und strahlentherapeutische Ansätze sowie medikamentöse Therapien in Abstimmung auf den Primarius. Dabei gewinnen biologische und pharmakologische Aspekte, die spezifisch für das ZNS sind, zunehmend an Bedeutung. Dieser Artikel gibt einen Überblick über den aktuellen Therapiestandard.
Literatur
1.
Zurück zum Zitat Ostrom QT et al. Brain metastases: epidemiology. Handb Clin Neurol. 2018;149:27-42 Ostrom QT et al. Brain metastases: epidemiology. Handb Clin Neurol. 2018;149:27-42
2.
Zurück zum Zitat Le Rhun E et al. EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours. Annals of Oncology. 2021;32(11):1332-47 Le Rhun E et al. EANO-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up of patients with brain metastasis from solid tumours. Annals of Oncology. 2021;32(11):1332-47
3.
Zurück zum Zitat Sperduto P W et al. Survival in Patients with Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient. J Clin Oncol. 2020;38(32):3773-84 Sperduto P W et al. Survival in Patients with Brain Metastases: Summary Report on the Updated Diagnosis-Specific Graded Prognostic Assessment and Definition of the Eligibility Quotient. J Clin Oncol. 2020;38(32):3773-84
4.
Zurück zum Zitat Soffietti R et al. Liquid biopsy in gliomas: A RANO review and proposals for clinical applications. Neuro-Oncology. 2022;24(6):855-71 Soffietti R et al. Liquid biopsy in gliomas: A RANO review and proposals for clinical applications. Neuro-Oncology. 2022;24(6):855-71
5.
Zurück zum Zitat Boire A et al. Liquid biopsy in central nervous system metastases: A RANO review and proposals for clinical applications. Neuro-Oncology. 2019;21(5):571-84 Boire A et al. Liquid biopsy in central nervous system metastases: A RANO review and proposals for clinical applications. Neuro-Oncology. 2019;21(5):571-84
6.
Zurück zum Zitat Thon N et al. Neurosurgical interventions for cerebral metastases of solid tumors. Dtsch Arztebl Int. 2023;120(10):162-9 Thon N et al. Neurosurgical interventions for cerebral metastases of solid tumors. Dtsch Arztebl Int. 2023;120(10):162-9
7.
Zurück zum Zitat Vogelbaum MA et al. Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline. J Clin Oncol. 2021;40(5):492-516 Vogelbaum MA et al. Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline. J Clin Oncol. 2021;40(5):492-516
8.
Zurück zum Zitat Yamamoto M et al. A Multi-institutional Prospective Observational Study of Stereotactic Radiosurgery for Patients With Multiple Brain Metastases (JLGK0901 Study Update): Irradiation-related Complications and Long-term Maintenance of Mini-Mental State Examination Scores. Int J Radiat Oncol Biol Phys. 2017;99(1):31-40 Yamamoto M et al. A Multi-institutional Prospective Observational Study of Stereotactic Radiosurgery for Patients With Multiple Brain Metastases (JLGK0901 Study Update): Irradiation-related Complications and Long-term Maintenance of Mini-Mental State Examination Scores. Int J Radiat Oncol Biol Phys. 2017;99(1):31-40
9.
Zurück zum Zitat Baschnagel AM et al. Tumor volume as a predictor of survival and local control in patients with brain metastases treated with Gamma Knife surgery. J Neurosurg. 2013;119(5):1139-44 Baschnagel AM et al. Tumor volume as a predictor of survival and local control in patients with brain metastases treated with Gamma Knife surgery. J Neurosurg. 2013;119(5):1139-44
10.
Zurück zum Zitat Mahajan A et al. Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1040-8 Mahajan A et al. Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-centre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1040-8
11.
Zurück zum Zitat Traylor JI et al. Fractionated stereotactic radiotherapy for local control of resected brain metastases. J Neurooncol. 2019;144(2):343-50 Traylor JI et al. Fractionated stereotactic radiotherapy for local control of resected brain metastases. J Neurooncol. 2019;144(2):343-50
12.
Zurück zum Zitat Turner BE et al. Nodular Leptomeningeal Disease - A Distinct Pattern of Recurrence After Postresection Stereotactic Radiosurgery for Brain Metastases: A Multi- institutional Study of Interobserver Reliability HHS Public Access. Int J Radiat Oncol Biol Phys. 2020;106(3):579-86 Turner BE et al. Nodular Leptomeningeal Disease - A Distinct Pattern of Recurrence After Postresection Stereotactic Radiosurgery for Brain Metastases: A Multi- institutional Study of Interobserver Reliability HHS Public Access. Int J Radiat Oncol Biol Phys. 2020;106(3):579-86
13.
Zurück zum Zitat Ladbury C et al. Stereotactic Radiosurgery in the Management of Brain Metastases: A Case-Based Radiosurgery Society (RSS) Practice Guideline: Brain Metastasis SRS RSS Practice Guideline. Adv Radiat Oncol. 2023;9(3):101402 Ladbury C et al. Stereotactic Radiosurgery in the Management of Brain Metastases: A Case-Based Radiosurgery Society (RSS) Practice Guideline: Brain Metastasis SRS RSS Practice Guideline. Adv Radiat Oncol. 2023;9(3):101402
14.
Zurück zum Zitat Dharnipragada R et al. Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis. World Neurosurg. 2024;182:35-41 Dharnipragada R et al. Preoperative Versus Postoperative Radiosurgery of Brain Metastases: A Meta-Analysis. World Neurosurg. 2024;182:35-41
15.
Zurück zum Zitat Das S et al. A phase III, multicenter, randomized controlled trial of preoperative versus postoperative stereotactic radiosurgery for patients with surgically resectable brain metastases. BMC Cancer. 2022;22(1):1368 Das S et al. A phase III, multicenter, randomized controlled trial of preoperative versus postoperative stereotactic radiosurgery for patients with surgically resectable brain metastases. BMC Cancer. 2022;22(1):1368
16.
Zurück zum Zitat Brown PD et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease: a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1049-60 Brown PD et al. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease: a multicentre, randomised, controlled, phase 3 trial. Lancet Oncol. 2017;18(8):1049-60
17.
Zurück zum Zitat Brown PD et al. Hippocampal Avoidance During Whole-Brain Radiotherapy Plus Memantine for Patients With Brain Metastases: Phase III Trial NRG Oncology CC001. J Clin Oncol. 2020;38(10):1019-29 Brown PD et al. Hippocampal Avoidance During Whole-Brain Radiotherapy Plus Memantine for Patients With Brain Metastases: Phase III Trial NRG Oncology CC001. J Clin Oncol. 2020;38(10):1019-29
18.
Zurück zum Zitat Brastianos PK et al. Genomic Characterization of Brain Metastases Reveals Branched Evolution and Potential Therapeutic Targets. Cancer Discov. 2015;5(11):1164-77 Brastianos PK et al. Genomic Characterization of Brain Metastases Reveals Branched Evolution and Potential Therapeutic Targets. Cancer Discov. 2015;5(11):1164-77
19.
Zurück zum Zitat Davies MA et al. Dabrafenib plus trametinib in patients with BRAF V600-mutant melanoma brain metastases (COMBI-MB): a multi-cohort, open-label, phase 2 trial. Lancet Oncol. 2017;18(7):863-73 Davies MA et al. Dabrafenib plus trametinib in patients with BRAF V600-mutant melanoma brain metastases (COMBI-MB): a multi-cohort, open-label, phase 2 trial. Lancet Oncol. 2017;18(7):863-73
20.
Zurück zum Zitat Gonzalez M et al. A phase II, open label, randomized controlled trial of nivolumab plus ipilimumab with stereotactic radiotherapy versus ipilimumab plus nivolumab alone in patients with melanoma brain metastases (ABC-X Trial) J Clin Oncol. 2019;37(15_suppl): TPS9600 Gonzalez M et al. A phase II, open label, randomized controlled trial of nivolumab plus ipilimumab with stereotactic radiotherapy versus ipilimumab plus nivolumab alone in patients with melanoma brain metastases (ABC-X Trial) J Clin Oncol. 2019;37(15_suppl): TPS9600
21.
Zurück zum Zitat Zhao Y et al. Overall survival benefit of osimertinib and clinical value of upfront cranial local therapy in untreated EGFR-mutant nonsmall cell lung cancer with brain metastasis. Int J Cancer. 2022;150(8):1318-28 Zhao Y et al. Overall survival benefit of osimertinib and clinical value of upfront cranial local therapy in untreated EGFR-mutant nonsmall cell lung cancer with brain metastasis. Int J Cancer. 2022;150(8):1318-28
22.
Zurück zum Zitat Murthy RK et al. Tucatinib, Trastuzumab, and Capecitabine for HER2-Positive Metastatic Breast Cancer. N Engl J Med. 2020;382(7):597-609 Murthy RK et al. Tucatinib, Trastuzumab, and Capecitabine for HER2-Positive Metastatic Breast Cancer. N Engl J Med. 2020;382(7):597-609
23.
Zurück zum Zitat Pérez-García JM et al. Trastuzumab deruxtecan in patients with central nervous system involvement from HER2-positive breast cancer: The DEBBRAH trial. Neuro Oncol. 2023; 25(1):157-66 Pérez-García JM et al. Trastuzumab deruxtecan in patients with central nervous system involvement from HER2-positive breast cancer: The DEBBRAH trial. Neuro Oncol. 2023; 25(1):157-66
24.
Zurück zum Zitat Bartsch R et al. Trastuzumab deruxtecan in HER2-positive breast cancer with brain metastases: a single-arm, phase 2 trial. Nat Med. 2022;28(9):1840-7 Bartsch R et al. Trastuzumab deruxtecan in HER2-positive breast cancer with brain metastases: a single-arm, phase 2 trial. Nat Med. 2022;28(9):1840-7
25.
Zurück zum Zitat Jacobson A. Trastuzumab Deruxtecan Improves Progression-Free Survival and Intracranial Response in Patients with HER2-Positive Metastatic Breast Cancer and Brain Metastases. Oncologist. 2022;27(Suppl 1):S3-4 Jacobson A. Trastuzumab Deruxtecan Improves Progression-Free Survival and Intracranial Response in Patients with HER2-Positive Metastatic Breast Cancer and Brain Metastases. Oncologist. 2022;27(Suppl 1):S3-4
26.
Zurück zum Zitat Jusino S et al. Systematic review of the management of brain metastases from hormone receptor positive breast cancer. J Neurooncol. 2023;162(1):45-57 Jusino S et al. Systematic review of the management of brain metastases from hormone receptor positive breast cancer. J Neurooncol. 2023;162(1):45-57
27.
Zurück zum Zitat Descourt R et al. First-line single-agent pembrolizumab for PD-L1-positive (tumor proportion score ≥ 50%) advanced non-small cell lung cancer in the real world: impact in brain metastasis: a national French multicentric cohort (ESCKEYP GFPC study). Cancer Immunol Immunother. 2023;72(1):91-9 Descourt R et al. First-line single-agent pembrolizumab for PD-L1-positive (tumor proportion score ≥ 50%) advanced non-small cell lung cancer in the real world: impact in brain metastasis: a national French multicentric cohort (ESCKEYP GFPC study). Cancer Immunol Immunother. 2023;72(1):91-9
28.
Zurück zum Zitat Hou X et al. Efficacy, Safety, and Health-Related Quality of Life With Camrelizumab Plus Pemetrexed and Carboplatin as First-Line Treatment for Advanced Nonsquamous NSCLC With Brain Metastases (CAP-BRAIN): A Multicenter, Open-Label, Single-Arm, Phase 2 Study. J Thorac Oncol. 2023;18(6):769-79 Hou X et al. Efficacy, Safety, and Health-Related Quality of Life With Camrelizumab Plus Pemetrexed and Carboplatin as First-Line Treatment for Advanced Nonsquamous NSCLC With Brain Metastases (CAP-BRAIN): A Multicenter, Open-Label, Single-Arm, Phase 2 Study. J Thorac Oncol. 2023;18(6):769-79
29.
Zurück zum Zitat Nadal E et al. Phase II Trial of Atezolizumab Combined With Carboplatin and Pemetrexed for Patients With Advanced Nonsquamous Non-Small-Cell Lung Cancer With Untreated Brain Metastases (Atezo-Brain, GECP17/05). J Clin Oncol. 2023;41(28):4478-85 Nadal E et al. Phase II Trial of Atezolizumab Combined With Carboplatin and Pemetrexed for Patients With Advanced Nonsquamous Non-Small-Cell Lung Cancer With Untreated Brain Metastases (Atezo-Brain, GECP17/05). J Clin Oncol. 2023;41(28):4478-85
30.
Zurück zum Zitat Tawbi HA et al. Long-term outcomes of patients with active melanoma brain metastases treated with combination nivolumab plus ipilimumab (CheckMate 204): final results of an open-label, multicentre, phase 2 study. Lancet Oncol. 2021;22(12):1692-704 Tawbi HA et al. Long-term outcomes of patients with active melanoma brain metastases treated with combination nivolumab plus ipilimumab (CheckMate 204): final results of an open-label, multicentre, phase 2 study. Lancet Oncol. 2021;22(12):1692-704
31.
Zurück zum Zitat Pace A et al. European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma. Lancet Oncol. 2017;18(6):e330-40 Pace A et al. European Association for Neuro-Oncology (EANO) guidelines for palliative care in adults with glioma. Lancet Oncol. 2017;18(6):e330-40
32.
Zurück zum Zitat Schmitt J et al. Initial Cancer Treatment in Certified Versus Non-Certified Hospitals. Dtsch Arztebl Int. 2023;120(39):647-54 Schmitt J et al. Initial Cancer Treatment in Certified Versus Non-Certified Hospitals. Dtsch Arztebl Int. 2023;120(39):647-54
Metadaten
Titel
Neuroonkologie
Interdisziplinäre Behandlungsstrategien bei Hirnmetastasen*
verfasst von
PD Dr. med. Pia Zeiner
Prof. Dr. med. Claus Rödel
Prof. Dr. med. Marcus Czabanka
Prof. Dr. med. Joachim Steinbach
Publikationsdatum
17.05.2024

Weitere Artikel der Ausgabe 5/2024

InFo Hämatologie + Onkologie 5/2024 Zur Ausgabe