Division of Molecular Oncology, Department of Translational Molecular Medicine, Saint John's Cancer Institute at Providence Saint John's Health Center, 2200 Santa Monica Blvd, Santa Monica, CA, 90404, USA.
Pacific Neuroscience Institute, Saint John's Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
Clin Exp Metastasis. 2022 Feb;39(1):61-69. doi: 10.1007/s10585-021-10094-y. Epub 2021 May 5.
Brain metastasis (BM) frequently occurs in patients with cutaneous melanoma, lung, and breast cancer; although, BM rarely arises from cancers of the gastrointestinal tract (GIT). The reported incidence of GIT cancer BM is less than 4%. In the last few years, effective systemic therapy has prolonged the survival of GIT patients and consequently, the incidence of developing BM is rising. Therefore, the epidemiology and biology of BM arising from GIT cancer requires a more comprehensive understanding. In spite of the development of new therapeutic agents for patients with metastatic GIT cancers, survival for patients with BM still remains poor, with a median survival after diagnosis of less than 4 months. Limited evidence suggests that early detection of isolated intra-cranial lesions will enable surgical resection plus systemic and/or radiation therapy, which may lead to an increase in overall survival. Novel diagnostic methods such as blood-based biomarker biopsies may play a crucial role in the early detection of BM. Circulating tumor cells and circulating cell-free nucleic acids are known to serve as blood biomarkers for early detection and treatment response monitoring of multiple cancers. Blood biopsy may improve early diagnosis and treatment monitoring of GIT cancers BM, thus prolonging patients' survivals.
脑转移（BM）常发生于皮肤黑色素瘤、肺癌和乳腺癌患者中；然而，胃肠道（GIT）癌症很少发生 BM。胃肠道癌症 BM 的报告发病率小于 4%。在过去几年中，有效的全身治疗延长了胃肠道癌症患者的生存期，因此，发生 BM 的发病率正在上升。因此，需要更全面地了解胃肠道癌症引起的 BM 的流行病学和生物学。尽管胃肠道转移性癌症患者的新治疗药物不断发展，但 BM 患者的生存仍然较差，诊断后中位生存期不到 4 个月。有限的证据表明，早期发现孤立性颅内病变将使手术切除联合全身和/或放射治疗成为可能，从而提高总体生存率。新型诊断方法，如基于血液的生物标志物活检，可能在 BM 的早期检测中发挥关键作用。循环肿瘤细胞和循环游离核酸已被用作多种癌症的血液生物标志物，用于早期检测和治疗反应监测。血液活检可能改善胃肠道癌症 BM 的早期诊断和治疗监测，从而延长患者的生存期。
