Brain metastasis
Brain metastases have a poor prognosis for cure, but modern treatments allow patients to live months and sometimes years after the diagnosis.
PET-imaging of brain metastases is however feasible using alternative radiotracers, such as the Gallium-68 labeled peptide 68Ga-Trivehexin,[13] a tracer targeting the tumor cell surface protein αvβ6-integrin.
[15] Treatment for brain metastases is primarily palliative, with the goals of therapy being reduction of symptoms and prolongation of life.
However, brain metastases harboring a mutation in the BRAF kinase at position V600 are effectively druggable with small molecule inhibitors such as dabrafenib.
[16] Recently, expression of NGFR was associated with progressive intracranial disease in melanoma patients [17] Additionally, there is limited evidence that the treatments that are offered takes account of patient-focused comparative effectiveness.
[6] However, it often causes severe side effects, including radiation necrosis, dementia, toxic leukoencephalopathy, partial to complete hair loss, nausea, headaches, and otitis media.
[23] An experimental treatment for brain metastases is intrathecal chemotherapy, a technique in which a chemotherapeutic drug is delivered via intralumbar injection into the cerebrospinal fluid.
[24] Current research on the treatment of brain metastases includes creating new drug molecules to effectively target the blood-brain barrier and studying the relationship between tumors and various genes.
[26] Immunotherapy, for instance Anti-PD-1 alone or in combination with anti-CTLA-4, appears to be effective in some patients with brain metastases especially when these are asymptomatic, stable and not previously treated.
[28][29] Moreover, methylome and transcriptome profiling of MBM revealed immune cell and microglia-enriched tumor subsets showing favorable outcome.
[6] However, in some patients, such as those with no extracranial metastases, those who are younger than 65, and those with a single site of metastasis in the brain only, prognosis is much better, with median survival rates of up to 13.5 months.
[36][37][38][39][40] However, recent trends in brain metastasis epidemiology have shown an increase in incidence for patients with renal, colorectal, or ovarian cancers.
However, many researchers have stated that population studies may express inaccurate data for brain metastases, given that surgeons have, in the past, been hesitant to take in patients with the condition.
