Department of Pathology, NYU Grossman School of Medicine, New York, USA.
Interdisciplinary Melanoma Cooperative Group, Perlmutter Cancer Center, NYU Langone Health, New York, USA.
Pigment Cell Melanoma Res. 2022 Nov;35(6):554-572. doi: 10.1111/pcmr.13059. Epub 2022 Sep 1.
Brain metastases are the most common brain malignancy. This review discusses the studies presented at the third annual meeting of the Melanoma Research Foundation in the context of other recent reports on the biology and treatment of melanoma brain metastases (MBM). Although symptomatic MBM patients were historically excluded from immunotherapy trials, efforts from clinicians and patient advocates have resulted in more inclusive and even dedicated clinical trials for MBM patients. The results of checkpoint inhibitor trials were discussed in conversation with current standards of care for MBM patients, including steroids, radiotherapy, and targeted therapy. Advances in the basic scientific understanding of MBM, including the role of astrocytes and metabolic adaptations to the brain microenvironment, are exposing new vulnerabilities which could be exploited for therapeutic purposes. Technical advances including single-cell omics and multiplex imaging are expanding our understanding of the MBM ecosystem and its response to therapy. This unprecedented level of spatial and temporal resolution is expected to dramatically advance the field in the coming years and render novel treatment approaches that might improve MBM patient outcomes.
脑转移瘤是最常见的颅内恶性肿瘤。本综述结合其他近期关于黑色素瘤脑转移瘤（MBM）生物学和治疗的报告，讨论了黑色素瘤研究基金会第三届年会上提出的研究。尽管有症状的 MBM 患者在历史上被排除在免疫治疗试验之外，但临床医生和患者倡导者的努力已经为 MBM 患者开展了更具包容性甚至专门的临床试验。免疫检查点抑制剂试验的结果与 MBM 患者的当前护理标准（包括类固醇、放疗和靶向治疗）进行了讨论。MBM 的基础科学理解方面的进展，包括星形胶质细胞的作用和对脑微环境的代谢适应，正在揭示新的弱点，这些弱点可能被用于治疗目的。技术进步，包括单细胞组学和多重成像，正在扩大我们对 MBM 生态系统及其对治疗反应的理解。这种前所未有的时空分辨率预计将在未来几年内极大地推动该领域的发展，并提出可能改善 MBM 患者预后的新治疗方法。
