Brain metastases (BM) significantly affect the prognosis as well as the quality of life of breast cancer (BC) patients. Although advancements in neurosurgical and radiotherapy techniques improve local control and symptom management, BM remains associated with a poor prognosis. In addition, the efficacy of currently approved systemic therapies in central nervous system (CNS) compartment is still limited, especially after progression on local therapy. The blood-brain barrier (BBB) has been recognized as a mechanism of primary resistance to many chemotherapeutic agents and targeted therapies due to low drug penetration. Other mechanisms of primary and secondary resistance are still unclear and may vary across the BC subtypes. New small molecules have demonstrated efficacy in BM, in particular for the HER2-positive subtype, with a benefit in survival. A new era has begun in the field of BM, and many trials specifically designed for this population are currently ongoing. The BC research community needs to address this call with the final aim of improving the efficacy of systemic therapy in CNS compartment and ultimately preventing the occurrence of BM.
Keyphrases
- brain metastases
- poor prognosis
- small cell lung cancer
- blood brain barrier
- healthcare
- end stage renal disease
- long non coding rna
- ejection fraction
- risk assessment
- newly diagnosed
- mental health
- radiation therapy
- chronic kidney disease
- palliative care
- peritoneal dialysis
- prognostic factors
- pain management
- drug induced
- quality improvement
- stem cells
- mesenchymal stem cells
- chronic pain
- radiation induced
- young adults
- rectal cancer
- replacement therapy
- electronic health record