Medication to Treat Lung Cancer may Improve Outcomes of Metastatic Brain Cancer

Medication used to treat non-small cell lung cancer that has metastasized, may benefit patients with metastatic brain cancers, according to a new review and analysis led by researchers at St. Michael's Hospital of Unity Health Toronto and Harvard Medical School.

Published in JAMA Network Open, the research hones in on osimertinib, a treatment recently approved in North America as a therapy for metastatic non-small cell lung cancer with a specific mutation.

‘Osimertinib used for metastatic non-small cell lung cancer with a specific mutation could treat patients with metastatic brain cancer without the need for surgery and radiation.’
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In a meta-analysis of 15 studies with 324 patients, researchers found that 64 per cent of patients with metastatic brain cancer whose cancer had spread from their lungs and were part of clinical trials with this therapy experienced a measurable response, and 90 per cent experienced disease control in the central nervous system. Up to 40 per cent of patients, however, reported severe side effects from the treatment.

"The development of brain metastases is an often feared complication of cancer," said Anders Erickson, a graduate student at St. Michael's Hospital in Dr. Sunit Das' lab, who led this research.

"Cancers that spread to the brain have historically required radical treatment with surgery or radiation. Chemotherapies that are capable of killing cancer cells in the rest of the body are unable to penetrate the blood-brain barrier."

Brain Metastasis - Causes, Symptoms, Diagnosis and Treatment
Brain metastases are caused by the spread of primary tumors to the brain. Lung, breast, melanoma are the three main tumors that cause brain metastases.

There is a lack of evidence to support the use of targeted therapy - or small molecules that target the specific drivers of a cancer - in metastatic brain disease. The researchers set out to fill this gap by further analyzing whether this targeted treatment, known for its ability to cross the blood-brain barrier, might be beneficial to patients whose lung cancer had spread to the brain.

"Though more research is needed, our study supports the potential role this therapy could play for patients," said Dr. Das, a scientist at the Keenan Research Centre for Biomedical Science and a neurosurgeon at St. Michael's.

"It suggests we may one day be able to treat these patients without the concerns associated with surgery and radiation."

The scientists aim to investigate this topic on a broader scale, looking at larger data sets to survey the impact of different targeted therapies for metastatic brain cancer.

"We hope our work will contribute to knowledge that will inform future treatment and move the needle for patients with metastatic brain cancer in the era of precision medicine," Erickson said.

Source-Eurekalert