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针对常见癌症原发灶脑转移的免疫治疗和靶向治疗策略:最新综述

Immunotherapeutic and Targeted Strategies for Managing Brain Metastases from Common Cancer Origins: A State-of-the-Art Review.

作者信息

Podder Vivek, Bellur Shreyas, Margolin Kim, Advani Pooja, Mahtani Reshma L, Subbiah Vivek, Novo Gabriella B, Ranjan Tulika, Ahluwalia Manmeet S

机构信息

Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.

Saint John's Cancer Institute, Santa Monica, CA, USA.

出版信息

Curr Oncol Rep. 2024 Dec;26(12):1612-1638. doi: 10.1007/s11912-024-01593-8. Epub 2024 Nov 8.

Abstract

PURPOSE OF REVIEW

This review examines contemporary strategies for managing brain metastases (BM) from common cancers such as lung, breast, and melanoma. We evaluate the efficacy and applicability of targeted therapies and immunotherapies, exploring their potential to cross the blood-brain barrier and improve patient outcomes.

RECENT FINDINGS

Recent studies have shown that tyrosine kinase inhibitors, immune checkpoint inhibitors, and ADCs effectively treat BM. These treatments can overcome the challenges posed by the blood-brain barrier and improve therapeutic outcomes. ADCs are promising because they can deliver cytotoxic agents directly to tumor cells, which reduces systemic toxicity and increases drug delivery efficiency to the brain. Personalized medicine is becoming increasingly significant in treatment decisions, with biomarkers playing an essential role. Advances in molecular genetics and drug development have led to more refined treatments, emphasizing the precision medicine framework. The management of BM is evolving, driven by drug efficacy, resistance mechanisms, and the need for personalized medicine. Integrating ADCs into treatment regimens represents a significant advancement in targeting metastatic brain tumors. Despite these advances, BM management still presents considerable challenges, requiring ongoing research and multi-institutional trials to optimize therapeutic strategies. This review outlines the current state and future directions in treating BM, highlighting the critical need for continued innovation and comprehensive clinical evaluations to improve survival rates and quality of life for affected patients.

摘要

综述目的

本综述探讨了针对肺癌、乳腺癌和黑色素瘤等常见癌症脑转移(BM)的当代管理策略。我们评估了靶向治疗和免疫治疗的疗效及适用性,探讨它们穿越血脑屏障并改善患者预后的潜力。

最新发现

近期研究表明,酪氨酸激酶抑制剂、免疫检查点抑制剂和抗体药物偶联物(ADC)可有效治疗脑转移。这些治疗方法能够克服血脑屏障带来的挑战并改善治疗效果。ADC很有前景,因为它们可将细胞毒性药物直接递送至肿瘤细胞,从而降低全身毒性并提高药物向脑部的递送效率。在治疗决策中,精准医学变得越来越重要,生物标志物发挥着至关重要的作用。分子遗传学和药物开发的进展带来了更精细的治疗方法,强调了精准医学框架。脑转移的管理正在不断发展,受到药物疗效、耐药机制以及精准医学需求的推动。将ADC纳入治疗方案代表了在靶向转移性脑肿瘤方面的重大进展。尽管取得了这些进展,但脑转移的管理仍然面临相当大的挑战,需要持续的研究和多机构试验来优化治疗策略。本综述概述了治疗脑转移的现状和未来方向,强调了持续创新和全面临床评估对于提高受影响患者生存率和生活质量的迫切需求。

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