Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China.
Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine (TCM) Prevention and Treatment of Tumor, Nanjing, China.
Cancer Med. 2018 Aug;7(8):3820-3833. doi: 10.1002/cam4.1667. Epub 2018 Jul 10.
Brain metastasis is an important cause of morbidity and mortality in cancer patients. Hence, the need to develop improved therapies to prevent and treat metastasis to the brain is becoming urgent. Recent studies in this area are bringing about some advanced progress on brain metastasis. It was concluded that the occurrence and poor prognosis of brain metastasis have been mostly attributed to the exclusion of anticancer drugs from the brain by the blood-brain barrier. And several highly potent new generation targeted drugs with enhanced CNS distribution have been developed constantly. However, the noted "seed and soil" hypothesis also suggests that the outcome of metastasis depends on the relationship between unique tumor cells and the specific organ microenvironment. Moreover, increasing studies in multiple tumor types demonstrated that brain metastasis has great molecular differences between primary tumors and extracranial metastasis to a large extent. Here, the authors summarized the most common malignancies that could lead to brain metastasis-lung cancer, breast cancer and melanoma and their related mutated factors. Only by comprehending a deeper understanding of the molecular mechanisms, more effective brain-specific therapies will be developed for brain metastasis.
脑转移是癌症患者发病率和死亡率的重要原因。因此,开发改善的疗法来预防和治疗脑转移变得越来越迫切。该领域的最新研究正在带来一些关于脑转移的先进进展。研究结论认为,血脑屏障阻止抗癌药物进入大脑,这是导致脑转移发生和预后不良的主要原因。不断开发出几种具有增强中枢神经系统分布的高效新型靶向药物。然而,著名的“种子和土壤”假说也表明,转移的结果取决于独特的肿瘤细胞与特定器官微环境之间的关系。此外,多项肿瘤类型的研究表明,脑转移在很大程度上具有与原发性肿瘤和颅外转移之间的显著分子差异。在这里,作者总结了最常见的可导致脑转移的恶性肿瘤——肺癌、乳腺癌和黑色素瘤,以及它们相关的突变因素。只有深入了解分子机制,才能开发出更有效的针对脑转移的脑特异性疗法。