Leptomeningeal carcinomatosis is cancer that has spread to the coating of the brain and spinal cord. In the past, prognosis has been bad. But now doctors are learning of effective treatments to deal with this issue.

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The doctors discuss the new FDA-approved drug for ALK positive lung cancer patients, Zykadia (ceritinib), including the dosage level, potential side effects and the ability of Zykadia to impact brain metastases.

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New treatments for ALK rearrangements are on the horizon. In this video, the doctors discuss how they determine whether or not they change treatments for their patients once they begin to show progression while on Xalkori (crizotinib).

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Xalkori (crizotinib) was one of the fastest approved drugs in cancer treatment history because of its high efficacy levels in ALK positive lung cancer patients. In this video, the doctors discuss what took place as it raced to approval, as well as the limitations and side effects of the drug.

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For non-small cell lung cancer patients with multiple brain metastases, the standard approach of whole brain radiotherapy is not necessarily standard for each and every patient. Each patient's specific situation may sometimes be best approached with various combinations of surgery, radiation, medical/systemic therapy, and non-cancer directed treatment.

Good morning, GRACErs.

Plenary

This is the second of two parts in the Reference Library by Dr. Gadgeel on small cell lung cancer.

Patients with Limited Stage Small Cell Lung Cancer

Brain metastases from NSCLC is almost a field of its own. This is because of the relatively high frequency with which metastases appear, the fact that they may return, even after treatment with whole brain radiation therapy (WBRT), and that our chemotherapy has long been considered to be ineffective against them. In fact, the extent of them as a problem is reflected in the number of thread questions on this subject in the GRACE forum.

In my last few weeks as a GRACE guest faculty, I have been struck by the number of forum discussions that deal with brain metastases. Brain metastases are a growing problem in non-small cell lung cancer (NSCLC), as well as in multiple other cancers. Why is this? Twenty years ago, patients who developed brain metastases were usually at the end-stage of their cancer, with widely metastatic disease and few systemic treatment options. The prognosis for these patients was very poor, but not really because of the brain metastases.

Since the anti-angiogenic agent avastin (bevacizumab) has been shown to confer a survival benefit in a subset of patients with previously untreated advanced NSCLC (see prior post), we have been struggling with questions of whether the restricted eligibility requirements in the pivotal initial avastin trial were necessary.