Caruso Gerardo, Garcia Moreira Cristofer Gonzalo, Iaboni Edvige, Tripodo Massimo, Ferrarotto Rosamaria, Abbritti Rosaria Viola, Conte Luana, Caffo Maria
Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy.
Service de Neurochirurgie, Hopital Laribosiere, 75010 Paris, France.
Int J Mol Sci. 2025 May 23;26(11):5018. doi: 10.3390/ijms26115018.
Melanoma, a malignant skin tumor, is the third skin tumor and the third cause of brain metastases. The development and introduction of systemic therapies, such as Braf inhibitors and checkpoint inhibitors, have guaranteed an increase in overall survival. The appearance of brain metastases, which determines a median survival of less than 5 months, represents a sign of systemic disease progression and tumor instability. In this view, in addition to systemic therapy, the therapeutic options can be surgery, stereotactic surgery, and whole-brain radiation therapy. However, it has been observed that the response to systemic therapies of brain metastatic lesions, compared to extracerebral ones, does not guarantee complete local tumor control, thus increasing the mortality and morbidity of patients. This phenomenon, tumor escape, makes systemic therapy partly ineffective. How melanoma cells migrate, cross the blood-brain barrier, and invade brain tissue is still being studied. The melanocytic metastatic brain tumor microenvironment and its assay seem to have a key role in the response and therefore in the progression of metastatic lesions. Through this work, the intent is to underline the importance of the brain tumor microenvironment and how it can influence tumor growth, its response to therapy, and the patient's overall survival.
黑色素瘤是一种恶性皮肤肿瘤，是第三常见的皮肤肿瘤以及脑转移的第三大原因。全身治疗方法的发展与应用，如BRAF抑制剂和检查点抑制剂，已使总生存期得以延长。脑转移的出现意味着系统性疾病进展和肿瘤不稳定，其患者的中位生存期不到5个月。从这个角度来看，除全身治疗外，治疗选择还可以是手术、立体定向手术和全脑放射治疗。然而，据观察，与脑外病变相比，脑转移病变对全身治疗的反应并不能保证肿瘤得到完全的局部控制，从而增加了患者的死亡率和发病率。这种肿瘤逃逸现象使得全身治疗部分失效。黑色素瘤细胞如何迁移、穿过血脑屏障并侵入脑组织仍在研究中。黑素细胞转移性脑肿瘤微环境及其检测似乎在反应中起着关键作用，因此在转移性病变的进展中也起着关键作用。通过这项工作，旨在强调脑肿瘤微环境的重要性以及它如何影响肿瘤生长、对治疗的反应和患者的总生存期。
