Skip to main content
Top
Published in: Current Oncology Reports 1/2012

01-02-2012 | Neuro-oncology (M Gilbert, Section Editor)

Chemoprevention for Brain Metastases

Authors: Van A. Trinh, Wen-Jen Hwu

Published in: Current Oncology Reports | Issue 1/2012

Login to get access

Abstract

With the advent of effective therapies for systemic disease control, the prevalence of brain metastases (BMs) has been increasing. Relapses in the brain are a major barrier to cure in many patients with lung cancer and other malignancies. Effective agents are needed to prophylactically treat micrometastatic disease in patients at high risk for BMs, thereby reducing the incidence. In this report, we review the pathogenesis of and clinical risk factors for BMs, obstacles to BM treatment, and BM chemoprevention in lung cancer, breast cancer, melanoma, and renal cell carcinoma.
Literature
1.
go back to reference Bendell JC, Domchek SM, Burstein HJ, et al. Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma. Cancer. 2003;97(12):2972–9.PubMedCrossRef Bendell JC, Domchek SM, Burstein HJ, et al. Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma. Cancer. 2003;97(12):2972–9.PubMedCrossRef
2.
go back to reference •• Paget S. The distribution of secondary growth in cancer of the breast. Lancet. 1889;133(3421):571–73. Over a century ago in 1889, the “seed and soil” theory was proposed by Stephen Paget to hypothesize what determined which organ should receive disseminated cancer cells. He was convinced that site of secondary growth was not a matter of chance but was the result of favorable interactions between tumor cells (the seeds) and organ microenvironment (the soil). CrossRef •• Paget S. The distribution of secondary growth in cancer of the breast. Lancet. 1889;133(3421):571–73. Over a century ago in 1889, the “seed and soil” theory was proposed by Stephen Paget to hypothesize what determined which organ should receive disseminated cancer cells. He was convinced that site of secondary growth was not a matter of chance but was the result of favorable interactions between tumor cells (the seeds) and organ microenvironment (the soil). CrossRef
3.
go back to reference •• Fidler IJ, Balasubramanian K, Lin Q, Kim SW, Kim SJ. The brain microenvironment and cancer metastasis. Moll Cells. 2010;30(2):93–8. The authors apply Paget’s “seed and soil” hypothesis to BMs and discuss recent understanding of cerebral neoplastic neovascularization and facilitatory role of astrocytes in the development of BMs, giving hope for new therapeutic approaches to treat this fatal disease.CrossRef •• Fidler IJ, Balasubramanian K, Lin Q, Kim SW, Kim SJ. The brain microenvironment and cancer metastasis. Moll Cells. 2010;30(2):93–8. The authors apply Paget’s “seed and soil” hypothesis to BMs and discuss recent understanding of cerebral neoplastic neovascularization and facilitatory role of astrocytes in the development of BMs, giving hope for new therapeutic approaches to treat this fatal disease.CrossRef
4.
go back to reference Chen AM, Jahan TM, Jablons DM, Garcia J, Larson DA. Risk of cerebral metastases and neurological death after pathological complete response to neoadjuvant therapy for locally advanced nonsmall–cell lung cancer: clinical implications for the subsequent management of the brain. Cancer. 2007;109(8):1668–75.PubMedCrossRef Chen AM, Jahan TM, Jablons DM, Garcia J, Larson DA. Risk of cerebral metastases and neurological death after pathological complete response to neoadjuvant therapy for locally advanced nonsmall–cell lung cancer: clinical implications for the subsequent management of the brain. Cancer. 2007;109(8):1668–75.PubMedCrossRef
5.
go back to reference Yamanaka R. Medical management of brain metastases from lung cancer (review). Oncol Rep. 2009;22(6):1269–76.PubMedCrossRef Yamanaka R. Medical management of brain metastases from lung cancer (review). Oncol Rep. 2009;22(6):1269–76.PubMedCrossRef
6.
go back to reference Huang Z, Brdlik C, Jin P, Shapard HM. A pan-HER approach for cancer therapy: background, current status and future development. Expert Opin Biol Ther. 2009;9(1):97–110.PubMedCrossRef Huang Z, Brdlik C, Jin P, Shapard HM. A pan-HER approach for cancer therapy: background, current status and future development. Expert Opin Biol Ther. 2009;9(1):97–110.PubMedCrossRef
7.
go back to reference Yatabe Y, Takahashi T, Mitsudomi T. Epidermal growth factor receptor gene amplification is acquired in association with tumor progression of EGFR-mutated lung cancer. Cancer Res. 2008;68(7):2106–11.PubMedCrossRef Yatabe Y, Takahashi T, Mitsudomi T. Epidermal growth factor receptor gene amplification is acquired in association with tumor progression of EGFR-mutated lung cancer. Cancer Res. 2008;68(7):2106–11.PubMedCrossRef
8.
go back to reference •• Bunn PA Jr, Dziadziusko R, Varella-Garcia M, Franklin WA, Witta SE, Kelly K. Hirsch FR. Biological markers for non-small cell lung cancer patient selection for epidermal growth factor receptor tyrosine kinase inhibitor therapy. Clin Cancer Res. 2006;12(12):3652–56. This article summarizes the results of studies using clinical or biological features to predict benefit from EGFR TKIs.PubMedCrossRef •• Bunn PA Jr, Dziadziusko R, Varella-Garcia M, Franklin WA, Witta SE, Kelly K. Hirsch FR. Biological markers for non-small cell lung cancer patient selection for epidermal growth factor receptor tyrosine kinase inhibitor therapy. Clin Cancer Res. 2006;12(12):3652–56. This article summarizes the results of studies using clinical or biological features to predict benefit from EGFR TKIs.PubMedCrossRef
9.
go back to reference Ciardiello F, Tortora G. EGFR antagonists in cancer treatment. N Engl J Med. 2008;358(11):1160–74.PubMedCrossRef Ciardiello F, Tortora G. EGFR antagonists in cancer treatment. N Engl J Med. 2008;358(11):1160–74.PubMedCrossRef
10.
go back to reference Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EFGR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomized, phase 3 study. Lancet Oncol. 2011;Epub ahead of print. Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EFGR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomized, phase 3 study. Lancet Oncol. 2011;Epub ahead of print.
11.
go back to reference • Heon S, Yeap BY, Britt GJ, et al. Development of central nervous system metastases in patients with advanced non-small cell lung cancer and somatic EF+GFR mutations treated with gefitinib or erlotinib. Clin Cancer Res. 2010;16(23):5873–82. This article reviews the results of a retrospective analysis to suggest a lower risk of brain relapse in patients with EGFR-mutated NSCLC who were initially treated with gefitinib or erlotinib. PubMedCrossRef • Heon S, Yeap BY, Britt GJ, et al. Development of central nervous system metastases in patients with advanced non-small cell lung cancer and somatic EF+GFR mutations treated with gefitinib or erlotinib. Clin Cancer Res. 2010;16(23):5873–82. This article reviews the results of a retrospective analysis to suggest a lower risk of brain relapse in patients with EGFR-mutated NSCLC who were initially treated with gefitinib or erlotinib. PubMedCrossRef
12.
go back to reference Sun M, Behrens C, Feng L, et al. HER family receptor abnormalities in lung cancer brain metastases and corresponding primary tumors. Clin Cancer Res. 2009;15(15):4829–37.PubMedCrossRef Sun M, Behrens C, Feng L, et al. HER family receptor abnormalities in lung cancer brain metastases and corresponding primary tumors. Clin Cancer Res. 2009;15(15):4829–37.PubMedCrossRef
13.
go back to reference Grinberg-Rashi H, Ofek E, Perelman M, et al. The expression of the three genes in primary non-small cell lung cancer is associated with metastatic spread to the brain. Clin Cancer Res. 2009;15(5):1755–61.PubMedCrossRef Grinberg-Rashi H, Ofek E, Perelman M, et al. The expression of the three genes in primary non-small cell lung cancer is associated with metastatic spread to the brain. Clin Cancer Res. 2009;15(5):1755–61.PubMedCrossRef
14.
go back to reference •• Rodriguez E, Lilenbaum RC. Small cell lung cancer: past, present, and future. Curr Oncol Rep. 2010;12(5):327–34. This article looks at the evolution of SCLC treatment and reviews the standard managements that are currently available, as well as ongoing clinical studies. PubMedCrossRef •• Rodriguez E, Lilenbaum RC. Small cell lung cancer: past, present, and future. Curr Oncol Rep. 2010;12(5):327–34. This article looks at the evolution of SCLC treatment and reviews the standard managements that are currently available, as well as ongoing clinical studies. PubMedCrossRef
15.
go back to reference Musolino A, Ciccolallo L, Panebianco M, et al. Multifactorial central nervous system recurrence susceptibility in patients with HER2-positive breast cancer. Cancer. 2011;117(7):1837–46.PubMedCrossRef Musolino A, Ciccolallo L, Panebianco M, et al. Multifactorial central nervous system recurrence susceptibility in patients with HER2-positive breast cancer. Cancer. 2011;117(7):1837–46.PubMedCrossRef
16.
go back to reference Chacon RD, Costanzo MV. Triple-negative breast cancer. Breast Cancer Res. 2010;12 Suppl 2:S3. Epub.PubMed Chacon RD, Costanzo MV. Triple-negative breast cancer. Breast Cancer Res. 2010;12 Suppl 2:S3. Epub.PubMed
17.
go back to reference • Hennecke H, Yerushalmi R, Woods R, et al. Metastatic behavior of breast cancer subtypes. J Clin Oncol. 2010;28(20):3271–77. This article demonstrates that breast cancer subtypes are associated with distinct pattern of metastatic spread and significant difference in survival post-relapse. CrossRef • Hennecke H, Yerushalmi R, Woods R, et al. Metastatic behavior of breast cancer subtypes. J Clin Oncol. 2010;28(20):3271–77. This article demonstrates that breast cancer subtypes are associated with distinct pattern of metastatic spread and significant difference in survival post-relapse. CrossRef
18.
go back to reference •• Arslan C, Dizdar O, Altundag K. Systemic treatment in breast-cancer patients with brain metastasis. Expert Opin Pharmacother. 2010;11(7):1089–100. This article reviews current experience with systemic therapies in the management of patients with BMs from breast cancer.PubMedCrossRef •• Arslan C, Dizdar O, Altundag K. Systemic treatment in breast-cancer patients with brain metastasis. Expert Opin Pharmacother. 2010;11(7):1089–100. This article reviews current experience with systemic therapies in the management of patients with BMs from breast cancer.PubMedCrossRef
19.
go back to reference Park YH, Park MJ, Ji SH, et al. Trastuzumab treatment improves brain metastasis outcomes through control and durable prolongation of systemic extracranial disease in HER2-overexpressing breast cancer patients. Br J Cancer. 2009;100(6):894–900.PubMedCrossRef Park YH, Park MJ, Ji SH, et al. Trastuzumab treatment improves brain metastasis outcomes through control and durable prolongation of systemic extracranial disease in HER2-overexpressing breast cancer patients. Br J Cancer. 2009;100(6):894–900.PubMedCrossRef
20.
go back to reference Kuhn J, Robins I, Mehta M, et al. Tumor sequestration of lapatinib (NABTC 04–01). Neurooncology. 2008;10:Abstr ET-05. Kuhn J, Robins I, Mehta M, et al. Tumor sequestration of lapatinib (NABTC 04–01). Neurooncology. 2008;10:Abstr ET-05.
21.
go back to reference Lin NU, Carey LA, Liu MC, et al. Phase II trial of lapatinib for brain metastases in patient swith humen epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol. 2008;26(12):1993–9.PubMedCrossRef Lin NU, Carey LA, Liu MC, et al. Phase II trial of lapatinib for brain metastases in patient swith humen epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol. 2008;26(12):1993–9.PubMedCrossRef
22.
go back to reference Lin NU, Dierras V, Paul D, et al. Multicenter phase II study of lapatinib in patients with brain metastases from HER2-positive breast cancer. Clin Cancer Res. 2009;15(4):1452–9.PubMedCrossRef Lin NU, Dierras V, Paul D, et al. Multicenter phase II study of lapatinib in patients with brain metastases from HER2-positive breast cancer. Clin Cancer Res. 2009;15(4):1452–9.PubMedCrossRef
23.
go back to reference Geyer CE, Martin A, Newstat B, et al. Lapatinib (L) plus capecitabine (C) in HER2+ advanced breast cancer (ABC): genomic and updated efficacy data. J Clin Oncol. 2007;25:Abstr 1035. Geyer CE, Martin A, Newstat B, et al. Lapatinib (L) plus capecitabine (C) in HER2+ advanced breast cancer (ABC): genomic and updated efficacy data. J Clin Oncol. 2007;25:Abstr 1035.
24.
go back to reference Boccardo F, Kaufman B, Baselga J, et al. Evaluation of lapatinib (Lap) plus capecitabine (Cap) in patients with brain metastases (BM) from HER2+ breast cancer (BC) enrolled in the Lapatinib Expanded Access Program (LEAP) and French Authorisation Temporaire d’ Utilisation (ATU). J Clin Oncol. 2008;26:Abstr 1094. Boccardo F, Kaufman B, Baselga J, et al. Evaluation of lapatinib (Lap) plus capecitabine (Cap) in patients with brain metastases (BM) from HER2+ breast cancer (BC) enrolled in the Lapatinib Expanded Access Program (LEAP) and French Authorisation Temporaire d’ Utilisation (ATU). J Clin Oncol. 2008;26:Abstr 1094.
25.
go back to reference Sutherland S, Ashley S, Miles D, et al. Treatment of HER2-positive metastatic breast cancer with lapatinib and capecitabine in the lapatinib expanded access programme, including efficacy in brain metastases—the UK experience. Br J Cancer. 2010;102(6):995–100.PubMedCrossRef Sutherland S, Ashley S, Miles D, et al. Treatment of HER2-positive metastatic breast cancer with lapatinib and capecitabine in the lapatinib expanded access programme, including efficacy in brain metastases—the UK experience. Br J Cancer. 2010;102(6):995–100.PubMedCrossRef
26.
go back to reference •• Lin NU, Eierman W, Greil R, et al. Randomized phase II study of lapatinib plus capecitabine or lapatinib plus topotecan for patients with HER2-positive breast cancer brain metastases. J Neurooncol. 2011;Epub ahead of print. This article describes the results of a phase 2 trial assessing the clinical activity of lapatinib and capecitabine combination in patients with BMs from breast cancer. It also expounds past and current experience with the combination in the management of this patient population as well as ongoing research to ascertain the role of lapatinib monotherapy or lapatinib plus capecitabine as chemoprevention against brain relapse from breast cancer. •• Lin NU, Eierman W, Greil R, et al. Randomized phase II study of lapatinib plus capecitabine or lapatinib plus topotecan for patients with HER2-positive breast cancer brain metastases. J Neurooncol. 2011;Epub ahead of print. This article describes the results of a phase 2 trial assessing the clinical activity of lapatinib and capecitabine combination in patients with BMs from breast cancer. It also expounds past and current experience with the combination in the management of this patient population as well as ongoing research to ascertain the role of lapatinib monotherapy or lapatinib plus capecitabine as chemoprevention against brain relapse from breast cancer.
27.
go back to reference Eigentler TK, Figl A, Krex D, et al. Number of metastases, serum lactate dehydrogenase level, and type of treatment are prognostic factors in patients with brain metastases of malignant melanoma. Cancer. 2011;117(8):1697–703.PubMedCrossRef Eigentler TK, Figl A, Krex D, et al. Number of metastases, serum lactate dehydrogenase level, and type of treatment are prognostic factors in patients with brain metastases of malignant melanoma. Cancer. 2011;117(8):1697–703.PubMedCrossRef
28.
go back to reference Zakrzewski J, Geraghty LN, Rose AE, et al. Clinical variables and primary tumor characteristics predictive of the development of melanoma brain metastases and post-brain metastases survival. Cancer. 2011;117(8):1711–20.PubMedCrossRef Zakrzewski J, Geraghty LN, Rose AE, et al. Clinical variables and primary tumor characteristics predictive of the development of melanoma brain metastases and post-brain metastases survival. Cancer. 2011;117(8):1711–20.PubMedCrossRef
29.
go back to reference Bedikian AY, Wei C, Detry M, et al. Predictive factors for the development of brain metastasis in advanced unresectable metastatic melanoma. Am J Clin Oncol. 2010;Epub ahead of print. Bedikian AY, Wei C, Detry M, et al. Predictive factors for the development of brain metastasis in advanced unresectable metastatic melanoma. Am J Clin Oncol. 2010;Epub ahead of print.
30.
go back to reference Raizer JJ, Hwu WJ, Panageas KS, et al. Brain and leptomeningeal metastases from cutaneous melanoma :survival outcomes based on clinical features. Neuro Oncol. 2008;10(2):199–207.PubMedCrossRef Raizer JJ, Hwu WJ, Panageas KS, et al. Brain and leptomeningeal metastases from cutaneous melanoma :survival outcomes based on clinical features. Neuro Oncol. 2008;10(2):199–207.PubMedCrossRef
31.
go back to reference •• Long GV, Kefford RF, Carr PJA, et al. Phase I/II study of GSK2118436, a selective inhibitor of V600 mutant (MUT) BRAF kinase: evidence of activity in melanoma brain metastases (METS). Ann Oncol. 2008;21(Suppl. 8), Abstr LBA27. This abstract describes the results of a phase 1/2 trial of GSK2118436, which demonstrated the activity of this agent in melanoma BMs. •• Long GV, Kefford RF, Carr PJA, et al. Phase I/II study of GSK2118436, a selective inhibitor of V600 mutant (MUT) BRAF kinase: evidence of activity in melanoma brain metastases (METS). Ann Oncol. 2008;21(Suppl. 8), Abstr LBA27. This abstract describes the results of a phase 1/2 trial of GSK2118436, which demonstrated the activity of this agent in melanoma BMs.
32.
go back to reference •• Margolin KA, Di Giacomo AM, Maio M. Brain metastasis in melanoma: clinical activity of CTLA-4 antibody therapy. Semin Oncol. 2008;37(5):468–72. This article reviews the results of a phase 2 trial of ipilimumab, which demonstrated similar clinical activity in melanoma BMs, and ongoing and future trials of combined cytotoxic and immunomodulatory therapy by US and Italian multicenter trial groups. CrossRef •• Margolin KA, Di Giacomo AM, Maio M. Brain metastasis in melanoma: clinical activity of CTLA-4 antibody therapy. Semin Oncol. 2008;37(5):468–72. This article reviews the results of a phase 2 trial of ipilimumab, which demonstrated similar clinical activity in melanoma BMs, and ongoing and future trials of combined cytotoxic and immunomodulatory therapy by US and Italian multicenter trial groups. CrossRef
33.
go back to reference •• Verma J, Jonasch E, Allen P, Tannir N, Mahajan A. Impact of tyrosine kinase inhibitors on the incidence of brain metastasis in metastatic renal cell carcinoma. Cancer. 2011;Epub ahead of print. This article reviews the results of a large retrospective study which demonstrated that treatment with small-molecule TKIs reduced the incidence of BMs. The study also identified that lung metastasis is a risk factor for BM development. •• Verma J, Jonasch E, Allen P, Tannir N, Mahajan A. Impact of tyrosine kinase inhibitors on the incidence of brain metastasis in metastatic renal cell carcinoma. Cancer. 2011;Epub ahead of print. This article reviews the results of a large retrospective study which demonstrated that treatment with small-molecule TKIs reduced the incidence of BMs. The study also identified that lung metastasis is a risk factor for BM development.
34.
go back to reference Gore ME, Hariharan S, Porta C, et al. Sunitinib in metastatic renal cell carcinoma patients with brain metastases. Cancer. 2011;117(3):501–9.PubMedCrossRef Gore ME, Hariharan S, Porta C, et al. Sunitinib in metastatic renal cell carcinoma patients with brain metastases. Cancer. 2011;117(3):501–9.PubMedCrossRef
35.
go back to reference Massard C, Zonierek J, Gross-Goupil M, Fizaki K, Szczylik C, Escudier B. Incidence of brain metastases in renal cell carcinoma treated with sorafenib. Ann Oncol. 2010;21(5):1027–31.PubMedCrossRef Massard C, Zonierek J, Gross-Goupil M, Fizaki K, Szczylik C, Escudier B. Incidence of brain metastases in renal cell carcinoma treated with sorafenib. Ann Oncol. 2010;21(5):1027–31.PubMedCrossRef
Metadata
Title
Chemoprevention for Brain Metastases
Authors
Van A. Trinh
Wen-Jen Hwu
Publication date
01-02-2012
Publisher
Current Science Inc.
Published in
Current Oncology Reports / Issue 1/2012
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-011-0200-1

Other articles of this Issue 1/2012

Current Oncology Reports 1/2012 Go to the issue

Neuro-oncology (M Gilbert, Section Editor)

Epidemiology of Brain Metastases

Neuro-oncology (M Gilbert, Section Editor)

Treatment of Brain Metastases: Chemotherapy

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine