Yale Cancer Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA.
Curr Oncol Rep. 2022 May;24(5):585-594. doi: 10.1007/s11912-022-01237-9. Epub 2022 Feb 25.
Among solid tumors, melanoma has the highest propensity for brain dissemination. Although newer treatment approaches have resulted in excellent control or elimination of brain metastasis in many patients, they remain the cause of significant morbidity and mortality. Here, we review recent preclinical and clinical studies to detail current understanding of the incidence, prognosis, biological characteristics, and treatments for melanoma brain metastases.
Clinical trials tailored to this patient population have demonstrated prolonged disease control with immune checkpoint inhibitors. Emerging clinical challenges include radiation necrosis and perilesional edema, phenomena that are rarely seen in other organs. Recent preclinical studies have resulted in improved understanding of the tumor microenvironment in the brain, providing insights into additional treatment approaches. The biological basis of brain tumor homing and survival within the central nervous system remain understudied. Additional preclinical and clinical studies will enhance our ability to prevent and treat brain metastases.
在实体肿瘤中，黑色素瘤最易发生脑转移。尽管新的治疗方法已使许多患者的脑转移得到了极好的控制或消除，但脑转移仍是导致高发病率和死亡率的主要原因。在此，我们综述了最近的临床前和临床研究，详细介绍了黑色素瘤脑转移的发病、预后、生物学特征和治疗的最新认识。
针对该患者人群的临床试验表明，免疫检查点抑制剂可延长疾病控制时间。新出现的临床挑战包括放射性坏死和瘤周水肿，这些现象在其他器官很少见。最近的临床前研究加深了对脑内肿瘤微环境的理解，为进一步的治疗方法提供了依据。脑肿瘤归巢和在中枢神经系统内存活的生物学基础仍研究不足。更多的临床前和临床研究将提高我们预防和治疗脑转移的能力。
