You are viewing AANS Neurosurgeon Volume 27, Number 1, 2018. View our current issue, Volume 27, Number 3, 2018

AANS Neurosurgeon | Volume 27, Number 1, 2018

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Brain metastases common and difficult to treat in ROS1 lung cancer

Increasingly, doctors are treating lung cancer based on the genetic rearrangements driving the disease. For example, cancers that are driven by changes in the genes ALKEGFR, and ROS1 can now all be paired with drugs that target these specific changes. However, these cancers are not only dangerous in the lung where they appear, but can become especially dangerous if they are able to metastasize to the brain – a common cause of death from lung cancer. And some targeted treatments work better than others against cancer that has spread to the brain.

A University of Colorado Cancer Center study explores the occurrence and treatment of brain metastases in stage IV ROS1-positive non-small cell lung cancer. Importantly, and in contrast with the findings of previous groups, brain metastases were found to be fairly common in stage IV ROS1-positive cancers. In this study, 36 percent of 33 ROS1 patients (compared with 34 percent of 115 ALK patients) tested positive for brain metastases at the time of diagnosis. When the rate of brain metastases at stage IV disease was compared across ROS1, ALK, EGFR, KRAS, and BRAF mutations, there was no statistically significant difference between the groups.

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