Recent advancements in the treatment of brain metastasis

Abstract

Recently, the treatment of metastatic brain tumors has evolved dramatically owing to rapid advances in radiation and medical therapy. In the case of radiation therapy, stereotactic radiotherapy is expanding and the maximum number of treatable metastases has increased. In addition, standard radiotherapy after surgical tumor resection is shifting from whole-brain irradiation to stereotactic/local irradiation. In the case of medical therapy, molecular-targeted therapy has been reported to be effective against brain metastases from non-small cell lung cancer, melanoma, and breast cancer with specific genetic abnormalities. The usefulness of immune checkpoint inhibitors has also been demonstrated in large-scale clinical trials. As drug therapy based on genetic abnormalities evolves, the importance of genetic testing is increasing and the treatment for metastatic brain tumors is advancing in line with the development of cancer genomic medicine. A combination of multiple modalities is required for the effective treatment of metastatic brain tumors, which means that the need for multidisciplinary teams will increase in the future.