Trends in immunotherapy for brain metastases
Mené sur 52 patients présentant des métastases cérébrales (18 mélanomes, 34 cancers du poumon non à petites cellules), cet essai non randomisé de phase II évalue l'efficacité, du point de vue du taux de réponse des métastases, et la toxicité du pembrolizumab
The CNS is a common site of disease progression, especially in melanoma and certain subclasses of non-small-cell lung cancers (NSCLC), and particularly those driven by ALK rearrangements or EGFR mutations. CNS involvement is reported at baseline in nearly 30% of patients with ALK-rearranged NSCLC, and can increase to 60% at the time of progression to treatments with ALK inhibitors, such as crizotinib. New ALK inhibitors have substantial CNS penetration. For example, alectinib is not a substrate for P-glycoprotein and, unlike crizotinib and ceretinib, it is not actively exported from the intracranial environment.