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Multidisciplinary patient-centered management of brain metastases and future directions

The incidence of brain metastasis is increasing as improvements in systemic therapy lead to increased survival. This provides new and challenging clinical decisions for patients who are trying to balance the risk of recurrence or progression with treatment-related side effects, and it requires appro...

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Autores principales: Palmer, Joshua D, Trifiletti, Daniel M, Gondi, Vinai, Chan, Michael, Minniti, Giuseppe, Rusthoven, Chad G, Schild, Steven E, Mishra, Mark V, Bovi, Joseph, Williams, Nicole, Lustberg, Maryam, Brown, Paul D, Rao, Ganesh, Roberge, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7415255/
https://www.ncbi.nlm.nih.gov/pubmed/32793882
http://dx.doi.org/10.1093/noajnl/vdaa034
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author Palmer, Joshua D
Trifiletti, Daniel M
Gondi, Vinai
Chan, Michael
Minniti, Giuseppe
Rusthoven, Chad G
Schild, Steven E
Mishra, Mark V
Bovi, Joseph
Williams, Nicole
Lustberg, Maryam
Brown, Paul D
Rao, Ganesh
Roberge, David
author_facet Palmer, Joshua D
Trifiletti, Daniel M
Gondi, Vinai
Chan, Michael
Minniti, Giuseppe
Rusthoven, Chad G
Schild, Steven E
Mishra, Mark V
Bovi, Joseph
Williams, Nicole
Lustberg, Maryam
Brown, Paul D
Rao, Ganesh
Roberge, David
author_sort Palmer, Joshua D
collection PubMed
description The incidence of brain metastasis is increasing as improvements in systemic therapy lead to increased survival. This provides new and challenging clinical decisions for patients who are trying to balance the risk of recurrence or progression with treatment-related side effects, and it requires appropriate management strategies from multidisciplinary teams. Improvements in prognostic assessment and systemic therapy with increasing activity in the brain allow for individualized care to better guide the use of local therapies and/or systemic therapy. Here, we review the current landscape of brain-directed therapy for the treatment of brain metastasis in the context of recent improved systemic treatment options. We also discuss emerging treatment strategies including targeted therapies for patients with actionable mutations, immunotherapy, modern whole-brain radiation therapy, radiosurgery, surgery, and clinical trials.
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spelling pubmed-74152552020-08-12 Multidisciplinary patient-centered management of brain metastases and future directions Palmer, Joshua D Trifiletti, Daniel M Gondi, Vinai Chan, Michael Minniti, Giuseppe Rusthoven, Chad G Schild, Steven E Mishra, Mark V Bovi, Joseph Williams, Nicole Lustberg, Maryam Brown, Paul D Rao, Ganesh Roberge, David Neurooncol Adv Reviews The incidence of brain metastasis is increasing as improvements in systemic therapy lead to increased survival. This provides new and challenging clinical decisions for patients who are trying to balance the risk of recurrence or progression with treatment-related side effects, and it requires appropriate management strategies from multidisciplinary teams. Improvements in prognostic assessment and systemic therapy with increasing activity in the brain allow for individualized care to better guide the use of local therapies and/or systemic therapy. Here, we review the current landscape of brain-directed therapy for the treatment of brain metastasis in the context of recent improved systemic treatment options. We also discuss emerging treatment strategies including targeted therapies for patients with actionable mutations, immunotherapy, modern whole-brain radiation therapy, radiosurgery, surgery, and clinical trials. Oxford University Press 2020-03-16 /pmc/articles/PMC7415255/ /pubmed/32793882 http://dx.doi.org/10.1093/noajnl/vdaa034 Text en © The Author(s) 2020. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Reviews
Palmer, Joshua D
Trifiletti, Daniel M
Gondi, Vinai
Chan, Michael
Minniti, Giuseppe
Rusthoven, Chad G
Schild, Steven E
Mishra, Mark V
Bovi, Joseph
Williams, Nicole
Lustberg, Maryam
Brown, Paul D
Rao, Ganesh
Roberge, David
Multidisciplinary patient-centered management of brain metastases and future directions
title Multidisciplinary patient-centered management of brain metastases and future directions
title_full Multidisciplinary patient-centered management of brain metastases and future directions
title_fullStr Multidisciplinary patient-centered management of brain metastases and future directions
title_full_unstemmed Multidisciplinary patient-centered management of brain metastases and future directions
title_short Multidisciplinary patient-centered management of brain metastases and future directions
title_sort multidisciplinary patient-centered management of brain metastases and future directions
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7415255/
https://www.ncbi.nlm.nih.gov/pubmed/32793882
http://dx.doi.org/10.1093/noajnl/vdaa034
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