Brain Metastases: Current Approaches and Perspectives

Brain metastases are frequent and dreadful complications of cancer especially lung, breast, colorectal and melanoma cancers. Advances in the past decade have resulted in a better understanding of the biology and molecular basis of brain metastases, resulting in more elaborate prognostic models, thereby expanding the range of perspectives for personalized medicine. The management of patients with brain metastases has evolved considerably; the therapeutic arsenal that was limited to conventional radiotherapy, systemic chemotherapy and surgery has expanded to include stereotaxic radiosurgery, immunotherapy and targeted therapy; this latter having a higher bioavailability beyond the blood-tumor barrier. In addition, advances in the field of neuroimaging, which has been enriched by functional imaging, currently allow precise targeting of brain lesions during treatment and help to differentiate the effects of treatment from the progression of the disease.

With the passage of these advances in the field of basic science to preclinical and clinical applications, it is almost certain that the future results of treatment of patients with brain metastases will improve.