Multidisciplinary patient-centered management of brain metastases and future directions

Joshua D. Palmer; Daniel M. Trifiletti; Vinai Gondi; Michael Chan; Giuseppe Minniti; Chad G. Rusthoven; Steven E. Schild; Mark V. Mishra; Joseph Bovi; Nicole Williams; Maryam Lustberg; Paul D. Brown; Ganesh Rao; David Roberge

doi:10.1093/noajnl/vdaa034

Multidisciplinary patient-centered management of brain metastases and future directions

Joshua D. Palmer, Daniel M. Trifiletti, Vinai Gondi, Michael Chan, Giuseppe Minniti, Chad G. Rusthoven, Steven E. Schild, Mark V. Mishra, Joseph Bovi, Nicole Williams, Maryam Lustberg, Paul D. Brown, Ganesh Rao, David Roberge

Research output: Contribution to journal › Article › peer-review

Abstract

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.

Original language	English (US)
Article number	vdaa034
Journal	Neuro-Oncology Advances
Volume	2
Issue number	1
DOIs	https://doi.org/10.1093/noajnl/vdaa034
State	Published - Jan 1 2020

Keywords

brain metastasis
radiosurgery
surgery
systemic therapy
treatment overview

ASJC Scopus subject areas

Clinical Neurology
Oncology
Surgery

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10.1093/noajnl/vdaa034

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title = "Multidisciplinary patient-centered management of brain metastases and future directions",

abstract = "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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author = "Palmer, {Joshua D.} and Trifiletti, {Daniel M.} and Vinai Gondi and Michael Chan and Giuseppe Minniti and Rusthoven, {Chad G.} and Schild, {Steven E.} and Mishra, {Mark V.} and Joseph Bovi and Nicole Williams and Maryam Lustberg and Brown, {Paul D.} and Ganesh Rao and David Roberge",

note = "Publisher Copyright: {\textcopyright} 2020 The Author(s) 2020. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.",

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doi = "10.1093/noajnl/vdaa034",

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AU - Gondi, Vinai

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AU - Minniti, Giuseppe

AU - Rusthoven, Chad G.

AU - Schild, Steven E.

AU - Mishra, Mark V.

AU - Bovi, Joseph

AU - Williams, Nicole

AU - Lustberg, Maryam

AU - Brown, Paul D.

AU - Rao, Ganesh

AU - Roberge, David

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KW - radiosurgery

KW - surgery

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KW - treatment overview

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Multidisciplinary patient-centered management of brain metastases and future directions

Abstract

Keywords

ASJC Scopus subject areas

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