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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...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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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. |
format | Online Article Text |
id | pubmed-7415255 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
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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