The article by Choi et al. describes different treatment options, such as surgery, radiation therapy and drugs. It also touches on more novel treatment options currently in development. Choi et al. explain the treatment and prevention of radiation toxicity, the negative effects on brain function due to radiotherapy. They outline specific pharmacologic (drug) treatment options for brain metastases spreading from the lung, the breast and the skin (melanoma). They address side effects and reasons not to use a specific drug (contraindications) for each of the listed drugs.
The article by Vogelbaum et al. focuses on recommendations to help doctors choose the most suitable treatment for patients. The article is very comprehensive and provides detailed information on when and if to have surgery, radiotherapy and systemic therapies (chemotherapy, immunotherapy, and targeted drugs). Treatments specific for brain metastases from the lung, breast, and skin (melanoma) are outlined. The treatment guidelines were developed by a group of experts who used the findings from a literature review on the latest clinical trials on treatments of brain metastases to formulate recommendations for doctors.
The guidelines were developed and approved by the American Society of Clinical Oncology (ASCO), the Society for Neuro-Oncology (SNO) and the American Society for Radiation Oncology (ASTRO). While these organisations are outside of Australia, the guidelines are based on international studies and apply to the Australian context also.
Overall, both papers show that there is no single treatment that suits everyone. The aim is to control the cancer while protecting memory, independence and quality of life. Doctors from different specialties need to work together to choose the best treatment for each person, based on the latest evidence and the patient’s needs and wishes.
In Australia, multidisciplinary care is considered best practice in the treatment planning and care for patients with cancer. Multidisciplinary (MDT) meetings are held so that relevant health care professionals come together and discuss options and make decisions on the best treatment and supportive care plans available, taking into account the personal preferences of the patient, their individual health status and tumour type.
The articles can be accessed under Vogelbaum et al. 2021/2022 and Choi et al. 2024 or downloaded below