Metastatic Brain Tumors: Chemotherapy – Treatment

00:01 The last treatment for brain metastases is chemotherapy.

00:04 And this is an option when local regional control, control with surgery or radiation to the area where the tumor is fails, or in patients who have widespread and multifocal disease that would lend itself to a systemic agent.

00:19 Unfortunately, not a lot of our systemic chemotherapies can get up into the brain because of the blood brain barrier.

00:25 So this really requires selecting the right agent that will get into the brain and target that tumor, which is the case for selected tumors and selected treatment.

00:35 Here you can see a list of some of those chemotherapy agents that target specific cancers and have favorable properties.

00:43 They're small drugs that get through the blood brain barrier.

00:47 I don't need you to know all of them, but that they exist.

00:50 Things like Capecitabine for breast cancer, Temozolomide for brain cancer, high-doses of medications like high-dose methotrexate for lymphoma, and then some new agents like this medicine Osimertinib, which targets certain types of lung cancer and immunotherapy.

01:07 How do patients do? What happens to brain metastases patients when they present? Well, if left untreated, this is a problem that can progress rapidly.

01:16 Within one to two months, patients can die from the progression of their brain tumor.

01:22 Treated. We see solitary or single treated brain metastasis.

01:26 The median survival patients live on average 14 to 15 months.

01:30 And in certain cases where we're able to combine both the surgery, radiation, as well as systemic therapy, we can see improvement in outcomes survival that doubles to eight months from four months in selected patients.

01:43 So this is a tough cancer to treat.