Women's Cancers Section, Laboratory of Molecular Pharmacology, National Cancer Institute, National Institute of Health, Bethesda, MD 20892, USA.
Eur J Cancer. 2010 May;46(7):1204-10. doi: 10.1016/j.ejca.2010.02.033. Epub 2010 Mar 19.
Central nervous system (CNS) or brain metastasis is an emerging area of interest in organ-specific metastasis research. Lung and breast cancers are the most common types of primary tumors to develop brain metastases. This disease complication contributes significantly to the morbidity and mortality of both of these common cancers; as such, brain metastasis is designated an unmet medical need by the US Food and Drug Administration (FDA). Recently, an increase in incidence of CNS disease has been noted in the literature for breast cancer, while it has been an ongoing major complication from lung cancer. Progress in treating brain metastases has been hampered by a lack of model systems, a lack of human tissue samples, and the exclusion of brain metastatic patients from many clinical trials. While each of those is significant, the major impediment to effectively treating brain metastatic disease is the blood-brain barrier (BBB). This barrier excludes most chemotherapeutics from the brain and creates a sanctuary site for metastatic tumors. Recent findings on the biology of this disease and translational leads identified by molecular studies are discussed in this article.
中枢神经系统(CNS)或脑转移是器官特异性转移研究中一个新兴的研究领域。肺癌和乳腺癌是最常见的原发性肿瘤类型,会发展为脑转移。这种疾病并发症是这两种常见癌症发病率和死亡率的主要原因;因此,美国食品和药物管理局(FDA)将脑转移指定为未满足的医疗需求。最近,文献中指出乳腺癌的 CNS 疾病发病率增加,而肺癌一直是主要的并发症。由于缺乏模型系统、缺乏人体组织样本以及许多临床试验排除脑转移患者,治疗脑转移的进展受到阻碍。虽然每一个都是重要的,但有效治疗脑转移疾病的主要障碍是血脑屏障(BBB)。该屏障将大多数化疗药物排除在大脑之外,并为转移性肿瘤创造了一个避难所。本文讨论了对这种疾病生物学的最新发现以及分子研究确定的转化线索。