TY - JOUR
T1 - The evolving modern management of brain metastasis
AU - Fecci, Peter E.
AU - Champion, Cosette D.
AU - Hoj, Jacob
AU - McKernan, Courtney M.
AU - Rory Goodwin, C.
AU - Kirkpatrick, John P.
AU - Anders, Carey K.
AU - Pendergast, Ann Marie
AU - Sampson, John H.
N1 - Publisher Copyright:
© 2019 American Association for Cancer Research.
PY - 2019/11/15
Y1 - 2019/11/15
N2 - The incidence of brain metastases is increasing as cancer therapies improve and patients live longer, providing new challenges to the multidisciplinary teams that care for these patients. Brain metastatic cancer cells possess unique characteristics that allow them to penetrate the blood–brain barrier, colonize the brain parenchyma, and persist in the intracranial environment. In addition, brain metastases subvert the innate and adaptive immune system, permitting evasion of the antitumor immune response. Better understanding of the above mechanisms will allow for development and delivery of more effective therapies for brain metastases. In this review, we outline the molecular mechanisms underlying development, survival, and immunosuppression of brain metastases. We also discuss current and emerging treatment strategies, including surgery, radiation, disease-specific and mutation-targeted systemic therapy, and immunotherapy.
AB - The incidence of brain metastases is increasing as cancer therapies improve and patients live longer, providing new challenges to the multidisciplinary teams that care for these patients. Brain metastatic cancer cells possess unique characteristics that allow them to penetrate the blood–brain barrier, colonize the brain parenchyma, and persist in the intracranial environment. In addition, brain metastases subvert the innate and adaptive immune system, permitting evasion of the antitumor immune response. Better understanding of the above mechanisms will allow for development and delivery of more effective therapies for brain metastases. In this review, we outline the molecular mechanisms underlying development, survival, and immunosuppression of brain metastases. We also discuss current and emerging treatment strategies, including surgery, radiation, disease-specific and mutation-targeted systemic therapy, and immunotherapy.
UR - https://www.scopus.com/pages/publications/85075092493
U2 - 10.1158/1078-0432.CCR-18-1624
DO - 10.1158/1078-0432.CCR-18-1624
M3 - Review article
C2 - 31213459
AN - SCOPUS:85075092493
SN - 1078-0432
VL - 25
SP - 6570
EP - 6580
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 22
ER -