Zhongguo Fei Ai Za Zhi. 2025 Jan 20;28(1):1-21. doi: 10.3779/j.issn.1009-3419.2024.102.42. Epub 2025 Jan 7.
Brain metastasis has emerged as a significant challenge in the comprehensive management of patients with non-small cell lung cancer (NSCLC), particularly in those harboring driver gene mutations. Traditional treatments such as radiotherapy and surgery offer limited clinical benefits and are often accompanied by cognitive dysfunction and a decline in quality of life. In recent years, novel small molecule tyrosine kinase inhibitors targeting epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), and other pathways have been developed, effectively penetrating the blood-brain barrier while enhancing intracranial drug concentrations and improving patient outcomes. This advancement has transformed the treatment landscape for brain metastases in NSCLC. Consequently, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association and the Brain Metastasis Collaboration Group of the Lung Cancer Youth Expert Committee of the Beijing Medical Reward Foundation have jointly initiated and formulated the Clinical Practice Guidelines for the Management of Brain Metastases from Non-small Cell Lung Cancer with Actionable Gene Alterations in China (2025 Edition). This guideline integrates the latest research findings with clinical experience, adhering to multidisciplinary treatment principles, and encompasses aspects such as diagnosis, timing of intervention, and systemic and local treatment options for driver gene positive NSCLC brain metastases. Additionally, it proposes individualized treatment strategies tailored to different driver gene types, aiming to provide clinicians with a reference to enhance the overall diagnostic and therapeutic standards for NSCLC brain metastases in China. .
脑转移已成为非小细胞肺癌(NSCLC)患者综合管理中的一项重大挑战,尤其是在那些携带驱动基因突变的患者中。放疗和手术等传统治疗方法的临床获益有限,且常伴有认知功能障碍和生活质量下降。近年来,针对表皮生长因子受体(EGFR)、间变性淋巴瘤激酶(ALK)等通路的新型小分子酪氨酸激酶抑制剂已被开发出来,它们能有效穿透血脑屏障,同时提高颅内药物浓度并改善患者预后。这一进展改变了NSCLC脑转移的治疗格局。因此,中国医学教育协会肺癌医学教育委员会和北京医学奖励基金会肺癌青年专家委员会脑转移协作组联合发起并制定了《中国非小细胞肺癌可 actionable 基因改变脑转移瘤诊疗临床实践指南(2025 版)》。本指南将最新研究成果与临床经验相结合,遵循多学科治疗原则,涵盖了驱动基因阳性NSCLC脑转移瘤的诊断、干预时机以及全身和局部治疗方案等方面。此外,它还针对不同驱动基因类型提出了个体化治疗策略,旨在为临床医生提供参考,以提高中国NSCLC脑转移瘤的整体诊断和治疗水平。