LS2 METASTATIC BRAIN TUMORS / MENINGIOMAS: CURRENT CONCEPTS AND THERAPEUTIC PERSPECTIVES

Non-glial brain tumors are the most common neoplasms affecting the central nervous system. Brain metastases are a heterogenous complication of systemic cancers. Recent research has provided insight into some important aspects of brain metastasis development, interaction of brain-metastatic tumor cells with resident cells of the CNS microenvironment and growth patterns within the brain parenchyma.Treatment choices have to consider clinical presentation, number, size and localisation of brain metastases, status of extracranial tumor burden, prior therapies, co-morbidities and histological and molecular tumor characteristics. Recent advances show that targeted therapies and immunotherapies have activity against established brain metastases and some targeted therapies are able to prevent brain metastasis development. Meningiomas are common and can be cured in 70–80% of cases by surgical resection. However, the rest of cases cannot be resected completey due to surgically inaccessibility (e.g. skull base) or show non-benign histopathological features that are associated with tumor recurrence. Meningiomas have been shown to be molecularly variable and carry distinct and reccurent genetic and epigenetic alterations that seem to enable targeted therapy and refined prognostication. Overall, significant advances in the biologcial understanding of brain metastases and meningiomas drive clinical trial design and improvement of clinical management strategies for these common tumors.