title: Brain metastasis:  opportunity for drug development?
abstract: OBJECTIVE
  Brain metastases are a common clinical problem, and only limited treatment options exist. We review recent advances in medical brain metastasis research with a focus on the most common tumor types associated with secondary brain colonization: melanoma, breast cancer and lung cancer. We speculate on opportunities for drug development in patients with brain metastases, both as a treatment of established disease and as an adjuvant and prophylactic strategy.
  
  
  RESULTS
  BRAF inhibitors and the immunomodulatory anticytotoxic T-lymphocyte-associated antigen 4 antibody ipilimumab have shown clinically meaningful activity in melanoma patients with brain metastases. In breast cancer, current studies on drug treatment of brain metastases are mainly focusing on human epidermal growth factor receptor 2 targeting agents such as lapatinib. Emerging data seem to implicate a potential role of targeted agents including antiangiogenic compounds, pazopanib, and epithelial growth factor receptor inhibitors for prevention of brain metastasis formation in breast cancer or nonsmall cell lung cancer.
  
  
  CONCLUSIONS
  Novel drugs are beginning to enter clinical practice for selected patients with brain metastases. The promising findings from recent studies may fuel more research on brain metastases and their optimal drug treatment.
authors.affiliation: Department of Medicine I and Comprehensive Cancer Center CNS Unit, Medical University of Vienna, Vienna, Austria. Matthias.preusser@meduniwien.ac.at
authors.forename: Matthias
authors.initials: M
authors.lastname: Preusser
authors.forename: Anna S
authors.initials: AS
authors.lastname: Berghoff
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
authors.forename: Nancy U
authors.initials: NU
authors.lastname: Lin
authors.forename: Roger
authors.initials: R
authors.lastname: Stupp
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000517:prevention & control / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D018890:Chemoprevention; D015195:Drug Design; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology; D008545:Melanoma / Q000473:pathology; D009369:Neoplasms / Q000473:pathology*
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents