Li Alyssa Y, Gaebe Karolina, Jerzak Katarzyna J, Cheema Parneet K, Sahgal Arjun, Das Sunit
Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Division of Oncology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Front Oncol. 2022 Mar 7;12:855182. doi: 10.3389/fonc.2022.855182. eCollection 2022.
Intracranial metastatic disease (IMD) is a prevalent complication of cancer that significantly limits patient survival and quality of life. Over the past half-century, our understanding of the epidemiology and pathogenesis of IMD has improved and enabled the development of surveillance and treatment algorithms based on prognostic factors and tumor biomolecular characteristics. In addition to advances in surgical resection and radiation therapy, the treatment of IMD has evolved to include monoclonal antibodies and small molecule antagonists of tumor-promoting proteins or endogenous immune checkpoint inhibitors. Moreover, improvements in the sensitivity and specificity of imaging as well as the development of new serological assays to detect brain metastases promise to revolutionize IMD diagnosis. In this review, we will explore current treatment principles in patients with IMD, including the emerging role of targeted and immunotherapy in select primary cancers, and discuss potential areas for further investigation.
颅内转移性疾病（IMD）是癌症的一种常见并发症，严重限制了患者的生存和生活质量。在过去的半个世纪里，我们对IMD的流行病学和发病机制的理解有所提高，并能够基于预后因素和肿瘤生物分子特征制定监测和治疗方案。除了手术切除和放射治疗方面的进展外，IMD的治疗已发展到包括单克隆抗体和肿瘤促进蛋白的小分子拮抗剂或内源性免疫检查点抑制剂。此外，成像的敏感性和特异性的提高以及用于检测脑转移的新血清学检测方法的开发有望彻底改变IMD的诊断。在这篇综述中，我们将探讨IMD患者当前的治疗原则，包括靶向治疗和免疫治疗在某些原发性癌症中的新兴作用，并讨论进一步研究的潜在领域。
