Treatment for Brain Metastases

Publication Date: December 21, 2021

Key Points

Key Points

In the United States, it is estimated that between 8% and 10% of patients with cancer will develop brain metastases representing ~200,000 new patients with brain metastases every year.

The most likely primary cancers to seed brain metastases are melanoma, lung adenocarcinoma, and those from lung, breast, melanoma, renal, kidney, esophagus, and, head and neck.

This guideline was developed by a multi-disciplinary team of medical oncologists, neurosurgeons, neuro-oncologists and radiation oncologists, and it integrates the latest evidence supporting the use of surgery, radiation, and medical therapies for patients with CNS metastases.

Treatment

...Treat...

...mendation 1.1Surgery may be offered for patient...


Recommendation 1.2Where surgery is considered, no...


...mmendation 1.3No recommendation can be made for or...


...dation 2.1Patients with symptomatic...


...2.2For patients with asymptomatic b...


....3 Osimertinib or icotinib may be offered to...


...ion 2.4Alectinib, brigatinib, or cer...


...2.5Pembrolizumab may be offered to patients with...


...2.6Ipilimumab plus nivolumab (for all patients...


...mendation 2.7The combination of tuc...


...3.1Radiation therapy should not be offered t...


...ommendation 3.2SRS alone (as opposed...


...3.3SRS alone should be offered to patients with 1...


...mmendation 3.4SRS, WBRT, and the combination...


...ion 3.5Memantine and hippocampal avoid...


...ecommendation 3.6Radiation sensitizi...


...on 4.1For patients who will receive...


...believes that cancer clinical trials ar...