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Research progress on radiotherapy for brain metastasis from non-small-cell lung cancer with ALK rearrangement
Wang Wenhui1, Sun Xin2, Hui Zhouguang2
1Department of Radiation Oncology,Peking Union Medical College Hospital,Chinese Academic of Medical Sciences,Beijing 100730,China; 2Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC),Beijing 100021,China
Abstract Brain metastasis is common in non-small-cell lung cancer (NSCLC) with driver gene mutations. At present, brain radiotherapy combined with tyrosine kinase inhibitor (TKI) is a hot topic. Anaplastic lymphoma kinase (ALK) gene rearrangement is one of the common driver mutations in NSCLC.However, the treatment of brain metastasis from NSCLC with ALK gene rearrangement has been rarely investigated. The prognosis of these patients,the role of brain radiotherapy and the proper combination of radiotherapy with ALK-TKI are worthy of further exploration.
Fund:National Key Research and Development Project (2017YFC1311000);Clinical Application Project of Beijing Municipal Commission of Science and Technology (Z171100001017114);Innovation Project of Medical and Health Science and Technology of the Chinese Academy of Medical Sciences (Major collaborative innovation project:2016-I2M-1-011);Beijing Marathon of Hope Special Foundation of Cancer Foundation of China (LC2016L03)
Wang Wenhui,Sun Xin,Hui Zhouguang. Research progress on radiotherapy for brain metastasis from non-small-cell lung cancer with ALK rearrangement[J]. Chinese Journal of Radiation Oncology, 2019, 28(6): 467-471.
Wang Wenhui,Sun Xin,Hui Zhouguang. Research progress on radiotherapy for brain metastasis from non-small-cell lung cancer with ALK rearrangement[J]. Chinese Journal of Radiation Oncology, 2019, 28(6): 467-471.
[1] Kwak EL,Bang YJ,Camidge DR,et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer[J].N Engl J Med,2010,363(18):1693-1703.DOI:10.1056/NEJMoa1006448. [2] Peters S,Camidge DR,Shaw AT,et al. Alectinib versus crizotinib in untreated ALK-positive non-small-cell lung cancer[J].N Engl J Med,2017,377(9):829-838.DOI:10.1056/NEJMoa1704795. [3] Guerin A,Sasane M,Zhang J,et al. Brain metastases in patients with ALK+ non-small cell lung cancer:clinical symptoms,treatment patterns and economic burden[J].J Med Econ,2015,18(4):312-322.DOI:10.3111/13696998.2014.1003644. [4] Metro G,Tazza M,Matocci R,et al. Optimal management of ALK-positive NSCLC progressing on crizotinib[J].Lung Cancer,2017,106(1):58-66.DOI:10.1016/j.lungcan.2017.02.003. [5] Sperduto PW,Yang TJ,Beal K,et al. Estimating survival in patients with lung cancer and brain metastases:an update of the graded prognostic assessment for lung cancer using molecular markers (Lung-molGPA)[J].JAMA Oncol,2017,3(6):827-831.DOI:10.1001/jamaoncol.2016.3834. [6] Rangachari D,Yamaguchi N,VanderLaan PA,et al. Brain metastases in patients with EGFR-mutated or ALK-rearranged non-small-cell lung cancers[J].Lung Cancer,2015,88(1):108-111.DOI:10.1016/j.lungcan.2015.01.020. [7] Sperduto PW,Kased N,Roberge D,et al. Summary report on the graded prognostic assessment:an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases[J].J Clin Oncol,2012,30(4):419-425.DOI:10.1200/JCO.2011.38.0527. [8] Camidge DR,Bang YJ,Kwak EL,et al. Activity and safety of crizotinib in patients with ALK-positive non-small-cell lung cancer:updated results from a phase 1 study[J].Lancet Oncol,2012,13(10):1011-1019.DOI:10.1016/S1470-2045(12)70344-3. [9] Solomon BJ,Mok T,Kim DW,et al. First-line crizotinib versus chemotherapy in ALK-positive lung cancer[J].N Engl J Med,2014,371(23):2167-2177.DOI:10.1056/NEJMoa1408440. [10] Shaw AT,Yeap BY,Solomon BJ,et al. Effect of crizotinib on overall survival in patients with advanced non-small-cell lung cancer harbouring ALK gene rearrangement:a retrospective analysis[J].Lancet Oncol,2011,12(11):1004-1012.DOI:10.1016/S1470-2045(11)70232-7. [11] Masters GA,Temin S,Azzoli CG,et al. Systemic therapy for stage Ⅳ non-small-cell lung cancer:American society of clinical oncology clinical practice guideline update[J].J Clin Oncol,2015,33(30):3488-3515.DOI:10.1200/JCO.2015.62.1342. [12] Weickhardt AJ,Scheier B,Burke JM,et al. Local ablative therapy of oligoprogressive disease prolongs disease control by tyrosine kinase inhibitors in oncogene-addicted non-small-cell lung cancer[J].J Thorac Oncol,2012,7(12):1807-1814.DOI:10.1097/JTO.0b013e3182745948. [13] Kim DW,Mehra R,Tan DS,et al. Activity and safety of ceritinib in patients with ALK-rearranged non-small-cell lung cancer (ASCEND-1):updated results from the multicentre,open-label,phase 1 trial[J].Lancet Oncol,2016,17(4):452-463.DOI:10.1016/S1470-2045(15)00614-2. [14] Crino L,Ahn MJ,De Marinis F,et al. Multicenter phase Ⅱ study of whole-body and intracranial activity with ceritinib in patients with ALK-rearranged non-small-cell lung cancer previously treated with chemotherapy and crizotinib:results from ASCEND-2[J].J Clin Oncol,2016,34(24):2866-2873.DOI:10.1200/JCO.2015.65.5936. [15] Ou SH,Ahn JS,De Petris L,et al. Alectinib in crizotinib-refractory ALK-rearranged non-small-cell lung cancer:a phase Ⅱ global study[J].J Clin Oncol,2016,34(7):661-668.DOI:10.1200/jco.2016.34.4_suppl.661. [16] Shaw AT,Gandhi L,Gadgeel S,et al. Alectinib in ALK-positive,crizotinib-resistant,non-small-cell lung cancer:a single-group,multicentre,phase 2 trial[J].Lancet Oncol,2016,17(2):234-242.DOI:10.1016/S1470-2045(15)00488-X. [17] Dai Y,Wei Q,Schwager C,et al. Synergistic effects of crizotinib and radiotherapy in experimental EML4-ALK fusion positive lung cancer[J].Radiother Oncol,2015,114(2):173-181.DOI:10.1016/j.radonc.2014.12.009. [18] Dai Y,Wei Q,Schwager C,et al. Oncogene addiction and radiation oncology:effect of radiotherapy with photons and carbon ions in ALK-EML4 translocated NSCLC[J].Radiat Oncol,2018,13(1):1.DOI:10.1186/s13014-017-0947-0. [19] Johung KL,Yao X,Li F,et al. A clinical model for identifying radiosensitive tumor genotypes in non-small cell lung cancer[J].Clin Cancer Res,2013,19(19):5523-5532.DOI:10.1158/1078-0432.CCR-13-0836. [20] Costa DB,Shaw AT,Ou SH,et al. Clinical experience with crizotinib in patients with advanced ALK-rearranged non-small-cell lung cancer and brain metastases[J].J Clin Oncol,2015,33(17):1881-1888.DOI:10.1200/JCO.2014.59.0539. [21] Yoshida T,Oya Y,Tanaka K,et al. Clinical impact of crizotinib on central nervous system progression in ALK-positive non-small lung cancer[J].Lung Cancer,2016,97(1):43-47.DOI:10.1016/j.lungcan.2016.04.006. [22] Soria JC,Tan DS,Chiari R,et al. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4):a randomised,open-label,phase 3 study[J].Lancet,2017,389(10072):917-929.DOI:10.1016/S0140-6736(17)30123-X. [23] Sun Y,Nowak KA,Zaorsky NG,et al. ALK inhibitor PF02341066(crizotinib) increases sensitivity to radiation in non-small cell lung cancer expressing EML4-ALK[J].Mol Cancer Ther,2013,12(5):696-704.DOI:10.1158/1535-7163.MCT-12-0868. [24] 吕嘉林,张权,秦娜,等.ALK阳性非小细胞肺癌脑转移患者的治疗[J].中国肺癌杂志,2016,19(8):519-524.DOI:10.3779/j.issn.1009-3419.2016.08.06. Lyu J,Zhang Q,Qin N,et al. Treatment of patients with ALK-positive non-small cell lung cancer and brain metastases][J].Chin Lung Cancer,2016,19(8):519-524.DOI:10.3779/j.issn.1009-3419.2016.08.06. [25] Kinoshita Y,Koga Y,Sakamoto A,et al. Long-lasting response to crizotinib in brain metastases due to EML4-ALK-rearranged non-small-cell lung cancer[J].BMJ Case Rep,2013, 2013(sep10 1).DOI:10.1136/bcr-2013-200867. [26] Kaneda H,Okamoto I,Nakagawa K.Rapid response of brain metastasis to crizotinib in a patient with ALK rearrangement-positive non-small-cell lung cancer[J].J Thorac Oncol.2013,8(4):e32-3. DOI:10.1097/JTO.0b013e3182843771. [27] Metro G,Lunardi G,Floridi P,et al. CSF concentration of crizotinib in two ALK-positive non-small-cell lung cancer patients with CNS metastases deriving clinical benefit from treatment[J].J Thorac Oncol,2015,10(5):e26-27.DOI:10.1097/JTO.0000000000000468. [28] Soria JC,Tan DSW,Chiari R,et al. First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4):a randomised,open-label,phase 3 study[J].Lancet,2017,389(10072):917-929.DOI:10.1016/S0140-6736(17)30123-X. [29] Costa DB,Kobayashi S,Pandya SS,et al. CSF concentration of the anaplastic lymphoma kinase inhibitor crizotinib[J].J Clin Oncol,2011,29(15):e443-445.DOI:10.1200/JCO.2010.34.1313. [30] Takeda M,Okamoto I,Nakagawa K.Clinical impact of continued crizotinib administration after isolated central nervous system progression in patients with lung cancer positive for ALK rearrangement[J].J Thorac Oncol,2013,8(5):654-657.DOI:10.1097/JTO.0b013e31828c28e7. [31] Ou SH,Janne PA,Bartlett CH,et al. Clinical benefit of continuing ALK inhibition with crizotinib beyond initial disease progression in patients with advanced ALK-positive NSCLC[J].Ann Oncol,2014,25(2):415-422.DOI:10.1093/annonc/mdt572. [32] Gadgeel SM,Shaw AT,Govindan R,et al. Pooled analysis of CNS response to alectinib in two studies of pretreated patients with ALK-positive non-small-cell lung cancer[J].J Clin Oncol,2016,34(34):4079-4085.DOI:10.1200/JCO.2016.68.4639. [33] Kim DW,Tiseo M,Ahn MJ,et al. Brigatinib in patients with crizotinib-refractory anaplastic lymphoma kinase-positive non-small-cell lung cancer:a randomized,multicenter phase Ⅱ trial[J].J Clin Oncol,2017,35(22):2490-2498.DOI:10.1200/JCO.2016.71.5904. [34] Aoyama H,Shirato H,Tago M,et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs. stereotactic radiosurgery alone for treatment of brain metastases:a randomized controlled trial[J].JAMA,2006,295(21):2483-2491.DOI:10.1001/jama.295.21.2483. [35] Aoyama H,Tago M,Shirato H,et al. Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases:secondary analysis of the JROSG 99-1 randomized clinical trial[J].JAMA Oncol,2015,1(4):457-564.DOI:10.1001/jamaoncol.2015.1145. [36] . Kocher M,Soffietti R,Abacioglu U,et al. Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases:results of the EORTC 22952-26001 study[J].J Clin Oncol,2011,29(2):134-141.DOI:10.1200/JCO.2010.30.1655. [37] Soffietti R,Kocher M,Abacioglu UM,et al. A European organisation for research and treatment of cancer phase Ⅲ trial of adjuvant whole-brain radiotherapy versus observation in patients with one to three brain metastases from solid tumors after surgical resection or radiosurgery:quality-of-life results[J].J Clin Oncol,2013,31(1):65-72.DOI:10.1200/JCO.2011.41.0639. [38] Sperduto PW,Shanley R,Luo X,et al. Secondary analysis of RTOG 9508,a phase 3 randomized trial of whole-brain radiation therapy versus WBRT plus stereotactic radiosurgery in patients with 1-3 brain metastases;poststratified by the graded prognostic assessment (GPA)[J].Int J Radiat Oncol Biol Phys,2014,90(3):526-531.DOI:10.1016/j.ijrobp.2014.07.002. [39] Bhatnagar AK,Flickinger JC,Kondziolka D,et al. Stereotactic radiosurgery for four or more intracranial metastases[J].Int J Radiat Oncol Biol Phys,2006,64(3):898-903.DOI:10.1016/j.ijrobp.2005.08.035. [40] Likhacheva A,Pinnix CC,Parikh NR,et al. Predictors of survival in contemporary practice after initial radiosurgery for brain metastases[J].Int J Radiat Oncol Biol Phys,2013,85(3):656-661.DOI:10.1016/j.ijrobp.2012.05.047. [41] Yamamoto M,Serizawa T,Shuto T,et al. Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901):a multi-institutional prospective observational study[J].Lancet Oncol,2014,15(4):387-395.DOI:10.1016/S1470-2045(14)70061-0. [42] Johung KL,Yeh N,Desai NB,et al. Extended survival and prognostic factors for patients with ALK-rearranged non-small-cell lung cancer and brain metastasis[J].J Clin Oncol,2016,34(2):123-129.DOI:10.1200/JCO.2015.62.0138. [43] Rusthoven CG,Doebele RC.Management of brain metastases in ALK-positive non-small-cell lung cancer[J].J Clin Oncol,2016,34(24):2814-2819.DOI:10.1200/JCO.2016.67.2410. [44] Molitoris JK,Edelman MJ,Regine WF,et al. Whole-brain radiation in the treatment of brain metastases in ALK-positive non-small-cell lung cancer[J].J Clin Oncol,2017,35(7):809-810.DOI:10.1200/JCO.2016.69.7227.
2019, Vol. 28 
