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.