Zykadia/brain mets - 1267230

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sagila
Zykadia/brain mets - 1267230

Hi
I would like to know if the new targeted therapy drug Zykadia will help metastasis of the brain. Will this medication reverse the metastasis or is it more advisable to undergo gamma knife to treat the mets in the brain?

catdander
Hello sagila, welcome to

Hello sagila, welcome to Grace.

Dr. West stated, " An additional important benefit of this agent, as well as several other second generation ALK inhibitors such as alectinib and AP26113, is that patients with brain metastases demonstrated responses. While XALKORI does not penetrate into the central nervous system (CNS), which is a “sanctuary site” in which we often see new disease appear in patients on XALKORI, Zykadia may be far better at preventing new disease from appearing in the CNS and can potentially treat pre-existing disease there. "
http://cancergrace.org/lung/2014/04/30/new-approval-for-zykadia-ldk378ce...

While it looks like it has the potential it's not a guarantee. In someone with brain mets without symptoms it might be worth a try though if symptoms are already present it maybe dangerous to wait and see if zykadia will work.

All best,
Janine

Dr West
Responses in the brain are

Responses in the brain are certainly possible, but they are often only partial. The activity within the brain of Zykadia (ceritinib) and other second generation ALK inhibitors hasn't been well characterized, but I don't consider them to be a clear substitute for gamma knife. I would be more inclined to favor a trial of them in people who either had radiation before or have brain metastases that are asymptomatic and perhaps small enough that you can afford to take a chance on the treatment not being as effective as radiation.

Good luck.

-Dr. West

+++++++++++++++++++++++++
Dr. Howard (Jack) West
Medical Oncologist
City of Hope Cancer Center
Duarte, CA

Founder & President
Global Resource for Advancing
Cancer Education