Stereotactic Radiosurgery and Immune Checkpoint Inhibitors in the Management of Brain Metastases.
Int J Mol Sci
; 19(10)2018 Oct 07.
Article
em En
| MEDLINE
| ID: mdl-30301252
ABSTRACT
Brain metastases traditionally carried a poor prognosis with an overall survival of weeks to months in the absence of treatment. Radiation therapy modalities include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS). WBRT delivers a relatively low dose of radiation, has neurocognitive sequelae, and has not been investigated for its immunostimulatory effects. Furthermore, WBRT exposes the entire intracranial tumor immune microenvironment to radiation. SRS delivers a high dose of conformal radiation with image guidance to minimize dose to surrounding normal brain tissue, and appears to promote anti-tumor immunity. In parallel with many of these discoveries, immune checkpoint inhibitors (ICIs) have demonstrated a survival advantage in multiple malignancies commonly associated with brain metastases (e.g., melanoma). Combination SRS and ICI are theorized to be synergistic in anti-tumor immunity directed to brain metastases. The purpose of this review is to explore the synergy of SRS and ICIs, including pre-clinical data, existing clinical data, and ongoing prospective trials.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Encefálicas
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Radiocirurgia
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Antineoplásicos Imunológicos
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Anticorpos Monoclonais
Tipo de estudo:
Guideline
Limite:
Humans
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article