Targeted Treatment of Brain Metastases.
Brain metastases are the most common intracranial tumors in adults. Historically, the median survival after the diagnosis of brain metastases has been dismal and medical therapies had a limited role in the management of these patients.



The advent of targeted therapy has ushered in an era of increased hope for patients with brain metastases. The most common malignancies that result in brain metastases-melanoma, lung cancer, and breast cancer, often have actionable mutations, which make them good candidates for targeted systemic therapy. These brain metastases have been shown to have relevant and sometimes divergent genetic alterations, and there has been a resurgence of interest in targeted drug delivery to the brain by using standard or pulsatile dosing to achieve adequate concentration in the brain. An increased understanding of oncogenic alterations, a surge in targeted drug development with good blood barrier penetration, and inclusion of patients with active brain metastases on clinical trials have led to improved outcomes for patients with brain metastases.
Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, USA.
Nicole
N
Shonka
University of Iowa Hospitals and Clinics, Iowa, USA.
Vyshak Alva
VA
Venur
Brain Metastasis Research Program, Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Medicine, Cleveland Clinic, Neurological Institute, 9500 Euclid Ave, S73, Cleveland, OH, 44195, USA. ahluwam@ccf.org.
Manmeet S
MS
Ahluwalia
D000818:Animals; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary; D002986:Clinical Trials as Topic; D016503:Drug Delivery Systems; D006801:Humans; D058990:Molecular Targeted Therapy; D009154:Mutation
ALK; Brain metastases; Clinical trials; EGFR; HER2; Targeted therapy