Unsanctifying the sanctuary: challenges and opportunities with brain metastases
While the use of targeted therapies, particularly radiosurgery, has broadened therapeutic options for CNS metastases, patients respond minimally and prognosis remains poor. The inability of many systemic chemotherapeutic agents to penetrate the blood-brain barrier (BBB) has limited their use and all...
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| Veröffentlicht in: | Neuro-oncology (Charlottesville, Va.) Va.), 2015-05, Vol.17 (5), p.639-651 |
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| container_title | Neuro-oncology (Charlottesville, Va.) |
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| creator | Puhalla, Shannon Elmquist, William Freyer, David Kleinberg, Lawrence Adkins, Chris Lockman, Paul McGregor, John Muldoon, Leslie Nesbit, Gary Peereboom, David Smith, Quentin Walker, Sara Neuwelt, Edward |
| description | While the use of targeted therapies, particularly radiosurgery, has broadened therapeutic options for CNS metastases, patients respond minimally and prognosis remains poor. The inability of many systemic chemotherapeutic agents to penetrate the blood-brain barrier (BBB) has limited their use and allowed brain metastases to become a burgeoning clinical challenge. Adequate preclinical models that appropriately mimic the metastatic process, the BBB, and blood-tumor barriers (BTB) are needed to better evaluate therapies that have the ability to enhance delivery through or penetrate into these barriers and to understand the mechanisms of resistance to therapy. The heterogeneity among and within different solid tumors and subtypes of solid tumors further adds to the difficulties in determining the most appropriate treatment approaches and methods of laboratory and clinical studies. This review article discusses therapies focused on prevention and treatment of CNS metastases, particularly regarding the BBB, and the challenges and opportunities these therapies present. |
| doi_str_mv | 10.1093/neuonc/nov023 |
| format | Article |
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The inability of many systemic chemotherapeutic agents to penetrate the blood-brain barrier (BBB) has limited their use and allowed brain metastases to become a burgeoning clinical challenge. Adequate preclinical models that appropriately mimic the metastatic process, the BBB, and blood-tumor barriers (BTB) are needed to better evaluate therapies that have the ability to enhance delivery through or penetrate into these barriers and to understand the mechanisms of resistance to therapy. The heterogeneity among and within different solid tumors and subtypes of solid tumors further adds to the difficulties in determining the most appropriate treatment approaches and methods of laboratory and clinical studies. This review article discusses therapies focused on prevention and treatment of CNS metastases, particularly regarding the BBB, and the challenges and opportunities these therapies present.</description><identifier>ISSN: 1522-8517</identifier><identifier>EISSN: 1523-5866</identifier><identifier>DOI: 10.1093/neuonc/nov023</identifier><identifier>PMID: 25846288</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Animals ; Antineoplastic Agents - pharmacokinetics ; Antineoplastic Agents - therapeutic use ; Blood-Brain Barrier - metabolism ; Brain Neoplasms - prevention & control ; Brain Neoplasms - secondary ; Brain Neoplasms - therapy ; Humans ; Reviews</subject><ispartof>Neuro-oncology (Charlottesville, Va.), 2015-05, Vol.17 (5), p.639-651</ispartof><rights>The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. 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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
| subjects | Animals Antineoplastic Agents - pharmacokinetics Antineoplastic Agents - therapeutic use Blood-Brain Barrier - metabolism Brain Neoplasms - prevention & control Brain Neoplasms - secondary Brain Neoplasms - therapy Humans Reviews |
| title | Unsanctifying the sanctuary: challenges and opportunities with brain metastases |
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