Recommended treatments to prevent met to brain while on crizotinib - 1273580

Hi fanos,

Welcome to GRACE. There isn't a preventive treatment recommended at this time, although there is a strategy for monitoring and treatment with focused radiation, a strategy which is discussed by Dr. Camidge in a GRACE podcast published just today. And if necessary to control disease in the brain, the second generation ALK/ROS1 inhibitors are better at crossing the blood brain barrier.

In the next few days, look for another GRACE podcast addressing the current lack of evidence favoring the use of those second generation inhibitors as first-line treatment.

In small cell lung cancer, which frequently spreads to the brain, prophylactic cranial irradiation (PCI), which is preventive whole brain radiation, is used to prevent brain metastases. But because the overall survival of ALK and ROS1 patients often stretches out to several years, PCI is not recommended because the long term effects of such radiation are more likely to appear over those extended periods of time.

JimC
Forum moderator

Hi fanos,

I just wanted to clarify that crizotinib does penetrate the bbb for some people though it's not known how to tell who that will be without trying.

All best,
Janine