Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press24810.17650/2222-1468-2016-6-4-30-34DIAGNOSIS AND TREATMENT OF HEAD AND NECK TUMORSДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ ГОЛОВЫ И ШЕИVEMURAFENIB IN TREATMENT OF MELANOMA WITH BRAIN METASTASESВЕМУРАФЕНИБ В ЛЕЧЕНИИ БОЛЬНЫХ МЕЛАНОМОЙ С МЕТАСТАЗАМИ В ГОЛОВНОЙ МОЗГNaskhletashviliD. R.НасхлеташвилиД. Р.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

Давид Романович Насхлеташвили.

115478 Москва, Каширское шоссе, 23, nas-david@yandex.ru

nas-david@yandex.ruGorbunovaV. A.ГорбуноваВ. А.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

BekyashevA. Kh.БекяшевА. Х.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

DemidovL. V.ДемидовЛ. В.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

KharkevichG. Yu.ХаркевичГ. Ю.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

BanovS. M.БановС. М.
Russian Federation

16 4th Tverskaya-Yamskaya  St., Moscow 125047

125047 Москва, 4-я Тверская-Ямская ул., 16

SamoylenkoI. V.СамойленкоИ. В.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

BaryshnikovK. А.БарышниковК. А.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

OrlovaK. V.ОрловаК. В.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

UtyashevI. А.УтяшевИ. А.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

PetenkoN. N.ПетенкоН. Н.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

MarkinaI. G.МаркинаИ. Г.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

MoskvinaE. A.МосквинаЕ. А.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

MedvedevS. V.МедведевС. В.
Russian Federation

23 Kashirskoe Shosse, Moscow,  115478

115478 Москва, Каширское шоссе, 23

N.N. Blokhin Russian Cancer Research CenterРоссийский онкологический научный центр имени Н.Н. БлохинаN.N. Burdenko Neurosurgery Research InstituteНаучно-исследовательский институт нейрохирургии имени академика Н. Н. Бурденко081220166430340804201708042017Copyright ©; 2016, Naskhletashvili D.R., Gorbunova V.A., Bekyashev A.K., Demidov L.V., Kharkevich G.Y., Banov S.M., Samoylenko I.V., Baryshnikov K.А., Orlova K.V., Utyashev I.А., Petenko N.N., Markina I.G., Moskvina E.A., Medvedev S.V.Copyright ©; 2016, Насхлеташвили Д.Р., Горбунова В.А., Бекяшев А.Х., Демидов Л.В., Харкевич Г.Ю., Банов С.М., Самойленко И.В., Барышников К.А., Орлова К.В., Утяшев И.А., Петенко Н.Н., Маркина И.Г., Москвина Е.А., Медведев С.В.2016Naskhletashvili D.R., Gorbunova V.A., Bekyashev A.K., Demidov L.V., Kharkevich G.Y., Banov S.M., Samoylenko I.V., Baryshnikov K.А., Orlova K.V., Utyashev I.А., Petenko N.N., Markina I.G., Moskvina E.A., Medvedev S.V.Насхлеташвили Д.Р., Горбунова В.А., Бекяшев А.Х., Демидов Л.В., Харкевич Г.Ю., Банов С.М., Самойленко И.В., Барышников К.А., Орлова К.В., Утяшев И.А., Петенко Н.Н., Маркина И.Г., Москвина Е.А., Медведев С.В.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/248

The effectiveness of traditional chemotherapy (with temozolomide, fotemustine, lomustine) alone or in combination with whole brain radiotherapy in melanoma patients with cerebral metastases does not exceed 7–10  % with no significant impact on survival, which is around 2–4  months. Targeted therapy helped to improve survival of patients with disseminated melanoma and BRAF V600 mutations. The use of targeted drugs in patients with brain metastases allows to control the tumor process and to succeed in treatment of cerebral metastases. According to currently available research data and our own results, the effectiveness of targeted therapy with vemurafenib in melanoma patients positive for BRAF V600 mutations with brain metastases reaches 18.0–44.5  % with median survival of 5.3–8.0  months. Evidences suggest that the use of vemurafenib in melanoma patients with brain metastases ensure effective disease control in most of the cases and has a significant advantage comparing to conventional chemotherapy and whole brain radiotherapy. According to the results of these studies vemurafenib can be recommended as a 1st line targeted drug for treatment of melanoma patients with BRAF V600 mutations and brain metastases. Despite the existence of blood-brain barrier and efflux systems, new targeted drugs showed promising results in treatment of brain metastases. Over the last few years we have enhanced our understanding of brain metastasis mechanisms, principles of blood-brain barrier functioning, and  ways  of  cancer  drugs penetration into  the  central  nervous system.  Targeted  therapy  is  constantly developing and  will play an increasing role in treatment of melanoma cerebral metastases in the future with finding of new targets.

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