Details

Autor(en) / Beteiligte

• Lehrer, Eric J
• McGee, Heather M
• Peterson, Jennifer L
• Vallow, Laura
• Ruiz-Garcia, Henry
• Zaorsky, Nicholas G
• Sharma, Sonam
• Trifiletti, Daniel M

Titel

Stereotactic Radiosurgery and Immune Checkpoint Inhibitors in the Management of Brain Metastases

Ist Teil von

• International journal of molecular sciences, 2018-10, Vol.19 (10), p.3054

Ort / Verlag

Switzerland: MDPI

Erscheinungsjahr

2018

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• Brain metastases traditionally carried a poor prognosis with an overall survival of weeks to months in the absence of treatment. Radiation therapy modalities include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS). WBRT delivers a relatively low dose of radiation, has neurocognitive sequelae, and has not been investigated for its immunostimulatory effects. Furthermore, WBRT exposes the entire intracranial tumor immune microenvironment to radiation. SRS delivers a high dose of conformal radiation with image guidance to minimize dose to surrounding normal brain tissue, and appears to promote anti-tumor immunity. In parallel with many of these discoveries, immune checkpoint inhibitors (ICIs) have demonstrated a survival advantage in multiple malignancies commonly associated with brain metastases (e.g., melanoma). Combination SRS and ICI are theorized to be synergistic in anti-tumor immunity directed to brain metastases. The purpose of this review is to explore the synergy of SRS and ICIs, including pre-clinical data, existing clinical data, and ongoing prospective trials.