We have detected that you are using an Ad Blocker. PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker.
We have sent a message to the email address you have provided, . If this email is not correct, please update your settings with your correct address.
The email address you provided during registration, , does not appear to be valid. Please update your settings with a valid address before to continue using PracticeUpdate.
No comments yet, be the first to start the discussion!
Jun 07, 2019
I agree to the practice update community guidelines very very useful in my oncology practice
Jun 07, 2019
For diffuse dural mets I would suggest tomotherapy to hit the target
Since dural mets from bladder ca is rare we do not have enough evidence at this point of time to suggest appropriate systemic therapy along with RT
Jun 09, 2019
There is always the question, "will the agent penetrate the blood brain barrier (BBB)?"
In the case of pembrolizumab, many would consider the monoclonal antibody too large to get through to the brain. But as a PD-1 inhibitor its site of action is on the immune cells where it protects them from the suppressive apoptotic signal from tumour-emitted PD-L1. Once so primed, the host immune cells then actively migrate to the tumour site, independent of the BBB.
Radiotherapy would enhance the efficacy of checkpoint inhibitors, but the patient must fully understand the side effects of WBRT which could be devastating. If the dural mets are not extensive, ciber knife RT may be considered.
Jul 06, 2022
Pending Moderator approval.
Are you sure you want to delete this comment? This can't be undone.