Prophylactic cranial irradiation for small cell lung cancer in the era of immunotherapy and molecular subtypes.

IF 2.8 4区 医学 Q2 ONCOLOGY Current Opinion in Oncology Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI:10.1097/CCO.0000000000001111
Veronika Pozonec, Maria Dorothea Pozonec, Clemens Aigner, Joachim Widder, Kristiina Boettiger, Zsolt Megyesfalvi, Balazs Dome
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Abstract

Purpose of review: Small cell lung cancer (SCLC) is an aggressive disease with a poor prognosis, whereas its metastatic capacity carries a predilection for the brain. Although prophylactic cranial irradiation (PCI) has been used to address this problem, upcoming alternatives might necessitate reflection of its application in SCLC treatment.

Recent findings: The addition of immunotherapy to treatment guidelines has provided a new strategy for the management of brain metastases. Complementation of immunotherapy with active MRI surveillance could potentially replace PCI and avoid irradiation-related cognitive side effects. SCLC's molecular profile is heterogeneous, with differential response to treatment modalities between subgroups. Investigation of these variances might be essential to improve therapeutic outcomes in SCLC patients.

Summary: The role of PCI in SCLC treatment must be examined in light of immunotherapy. We summarize recent results, bearing SCLC subtypes and therapeutic vulnerabilities in mind, to derive tailored treatment strategies for SCLC patients in future settings.

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免疫治疗和分子亚型时代小细胞肺癌的预防性颅脑照射。
综述目的:小细胞肺癌(SCLC)是一种预后不良的侵袭性疾病,其转移能力倾向于脑部。虽然预防性颅脑照射(PCI)已被用于解决这一问题,但未来的替代方案可能需要反思其在SCLC治疗中的应用。最近的发现:在治疗指南中加入免疫疗法为脑转移的治疗提供了一种新的策略。免疫治疗与主动MRI监测的补充可能潜在地取代PCI,并避免辐射相关的认知副作用。SCLC的分子特征是异质性的,不同亚组对治疗方式的反应不同。研究这些差异可能对改善SCLC患者的治疗效果至关重要。总结:PCI在SCLC治疗中的作用必须结合免疫治疗来考察。我们总结了最近的研究结果,考虑到SCLC亚型和治疗脆弱性,以便在未来的环境中为SCLC患者提供量身定制的治疗策略。
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来源期刊
Current Opinion in Oncology
Current Opinion in Oncology 医学-肿瘤学
CiteScore
6.10
自引率
2.90%
发文量
130
审稿时长
4-8 weeks
期刊介绍: With its easy-to-digest reviews on important advances in world literature, Current Opinion in Oncology offers expert evaluation on a wide range of topics from sixteen key disciplines including sarcomas, cancer biology, melanoma and endocrine tumors. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by annotated references detailing the merits of the most important papers.
期刊最新文献
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