TY - JOUR
T1 - Prophylactic cranial irradiation for small cell lung cancer in the era of immunotherapy and molecular subtypes
AU - Pozonec, Veronika
AU - Pozonec, Maria Dorothea
AU - Aigner, Clemens
AU - Widder, Joachim
AU - Boettiger, Kristiina
AU - Megyesfalvi, Zsolt
AU - Dome, Balazs
PY - 2025/1/1
Y1 - 2025/1/1
N2 - PURPOSE OF REVIEW: Small cell lung cancer (SCLC) is an aggressive disease with a poor prognosis, whereas its metastatic capacity carries a predilection for the brain. Although prophylactic cranial irradiation (PCI) has been used to address this problem, upcoming alternatives might necessitate reflection of its application in SCLC treatment. RECENT FINDINGS: The addition of immunotherapy to treatment guidelines has provided a new strategy for the management of brain metastases. Complementation of immunotherapy with active MRI surveillance could potentially replace PCI and avoid irradiation-related cognitive side effects. SCLC's molecular profile is heterogeneous, with differential response to treatment modalities between subgroups. Investigation of these variances might be essential to improve therapeutic outcomes in SCLC patients. SUMMARY: The role of PCI in SCLC treatment must be examined in light of immunotherapy. We summarize recent results, bearing SCLC subtypes and therapeutic vulnerabilities in mind, to derive tailored treatment strategies for SCLC patients in future settings.
AB - PURPOSE OF REVIEW: Small cell lung cancer (SCLC) is an aggressive disease with a poor prognosis, whereas its metastatic capacity carries a predilection for the brain. Although prophylactic cranial irradiation (PCI) has been used to address this problem, upcoming alternatives might necessitate reflection of its application in SCLC treatment. RECENT FINDINGS: The addition of immunotherapy to treatment guidelines has provided a new strategy for the management of brain metastases. Complementation of immunotherapy with active MRI surveillance could potentially replace PCI and avoid irradiation-related cognitive side effects. SCLC's molecular profile is heterogeneous, with differential response to treatment modalities between subgroups. Investigation of these variances might be essential to improve therapeutic outcomes in SCLC patients. SUMMARY: The role of PCI in SCLC treatment must be examined in light of immunotherapy. We summarize recent results, bearing SCLC subtypes and therapeutic vulnerabilities in mind, to derive tailored treatment strategies for SCLC patients in future settings.
U2 - 10.1097/CCO.0000000000001111
DO - 10.1097/CCO.0000000000001111
M3 - Review article
C2 - 39625049
AN - SCOPUS:85211423189
SN - 1040-8746
VL - 37
SP - 27
EP - 34
JO - Current Opinion in Oncology
JF - Current Opinion in Oncology
IS - 1
ER -
