title: Brain metastases: still an 'orphan' disease?
abstract: The diagnosis of brain metastases from systemic cancer has been associated with a poor prognosis. In fact, most chemotherapy clinical trials exclude patients with metastatic disease. In the past, clinical and basic research activity in this area has been only moderate. Recent developments in clinical trial design, as evidenced by recursive partitioning analysis and complemented by new treatment strategies in neurosurgery and radiotherapy, suggest a change in attitude and approach to the management of brain metastases. The role of chemotherapy will require more focused investigation, but recent advances in our understanding of the biology of brain metastases suggest that the next generation of chemotherapy treatments will involve targeting specific pathways of metastatic disease.
authors.affiliation: Department of Clinical Neuro-Oncology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 0100, Houston, TX 77030, USA. mrgilbert@mdanderson.org
authors.forename: M R
authors.initials: MR
authors.lastname: Gilbert
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy*; D002986:Clinical Trials as Topic / Q000639:trends; D003131:Combined Modality Therapy; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010347:Patient Care Planning; D011379:Prognosis
chemical_list: D000970:Antineoplastic Agents