Management of Brain Metastases from Solid Tumors

Abstract

Brain metastases (BM) are most common intracranial tumors in adults. Recently, significant progress has been shown in diagnosing, prognosis, and treating patients with BM of various malignant tumors. The treatment decisions must be based on the disease prognosis and include radiation therapy, surgery, systemic antitumor therapy, or a combination thereof. Systemic therapy capable of preventing BM or which affects both intracranial and extracranial disease is of paramount importance in the treatment of BM patients. The purpose of this chapter is to consider important prognostic factors that can determine treatment decisions, review the role of blood-brain barrier (BBB), and systemic anticancer treatment to manage BM from solid tumors.

Systemic chemotherapeutic treatment of patients with breast cancer brain metastases

“…All malignant tumors are capable of producing BM in a varying degree. About 75% of all cases of BM occur in patients with lung cancer (40-50%), breast cancer (BC) (15-25%) and melanoma (5-20%) [1]. BM risk depends on the molecular subtype of BC.…”

“…The presence of BM significantly worsens BC prognosis and decreases the median overall survival (OS) of patients depending on a number of factors that need to be considered for determining treatment options [1]. The prognostic importance of the clinical factors, morphological and molecular type of the primary tumor, Modified Breast Graded Prognostic Assessment (mB-GPA) for patients with BCBM has been developed with scores accounting for the age of patients, the number of metastases and the molecular subtypes of BC [3].…”