Embracing rejection: Immunologic trends in brain metastasis.
Brain metastases represent the most common type of brain tumor. These tumors offer a dismal prognosis and significantly impact quality of life for patients. Their capacity for central nervous system (CNS) invasion is dependent upon induced disruptions to the blood-brain barrier (BBB), alterations to the brain microenvironment, and mechanisms for escaping CNS immunosurveillance. In the emerging era of immunotherapy, understanding how metastases are influenced by the immunologic peculiarities of the CNS will be crucial to forging therapeutic advances. In this review, the immunology of brain metastasis is explored.
Duke Brain Tumor Immunotherapy Program, Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA.
S Harrison
SH
Farber
Duke Brain Tumor Immunotherapy Program, Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA.
Vadim
V
Tsvankin
The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA; Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Jessica L
JL
Narloch
The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA; Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Grace J
GJ
Kim
Division of Medical Oncology, Duke University Medical Center , Durham, NC, USA.
April K S
AK
Salama
The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA; Division of Medical Oncology, Duke University Medical Center, Durham, NC, USA.
Gordana
G
Vlahovic
The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA; Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
Kimberly L
KL
Blackwell
The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA; Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA.
John P
JP
Kirkpatrick
Duke Brain Tumor Immunotherapy Program, Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA; The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, USA; Department of Pathology, Duke University Medical Center, Durham, NC, USA.
Peter E
PE
Fecci
Blood–brain barrier; brain metastasis; immune checkpoint blockade; immunotherapy; tumor microenvironment