Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Biochem Pharmacol. 2012 Feb 1;83(3):305-14. doi: 10.1016/j.bcp.2011.09.012. Epub 2011 Sep 17.
One of the foremost challenges in oncology is developing improved therapies for preventing and treating metastases to the brain. Recent research in this area is bringing about a shift in the understanding of brain metastases. Previously, the occurrence and poor outcomes associated with brain metastases have been largely attributed to the exclusion of anticancer drugs from the brain by the blood-brain barrier (BBB). However, studies in multiple tumor types have also demonstrated that brain metastases have significant molecular differences from primary tumors and extracranial metastases. These molecular differences may not only promote the formation of brain metastases, but they may also contribute to these tumors' poor responsiveness to therapies. Such changes may be intrinsic to the cancer cells or driven by unique interactions with the brain microenvironment. An improved understanding of the molecular characteristics of brain metastases that contribute to their aggressive behaviors will facilitate the development of rational, more effective treatments for these tumors.
在肿瘤学领域,面临的主要挑战之一是开发改善的疗法,以预防和治疗脑转移。该领域的最新研究正在改变人们对脑转移的理解。以前,脑转移的发生和不良预后在很大程度上归因于血脑屏障 (BBB) 使抗癌药物无法进入大脑。然而,多项肿瘤类型的研究还表明,脑转移与原发性肿瘤和颅外转移具有显著的分子差异。这些分子差异不仅可能促进脑转移的形成,而且可能导致这些肿瘤对治疗的反应不佳。这些变化可能是癌细胞固有的,也可能是由与脑微环境的独特相互作用驱动的。对导致脑转移侵袭性行为的分子特征的深入了解,将有助于开发针对这些肿瘤的合理、更有效的治疗方法。