European Journal of Biomedical and Pharmaceutical Sciences

BRAIN METASTASES: NEW TRENDS IN TREATMENT INDIVIDUALISATION

Michael J. McKay MBBS(Hons), FRANZCR, PhD, MD* and Richard Foster MBBS, FRANZCR

ABSTRACT

Background: Brain metastases (BM) are the most common neurological manifestation of cancer and a key cause of morbidity. In 2020, there were just under 150,000 cancer cases in Australia, of whom over 20% will develop BM. BM are increasing in frequency as a result of an ageing population, more sensitive methods of detection and a longer cancer patient life expectancy. Cancers of origin of BM include lung cancer, melanoma, breast, renal and colorectal cancers. Different molecular subtypes of cancers effects BM incidence, as well as guiding treatment selection. Objectives: Here, the clinical features and modern management of brain metastases, with an emphasis on treatment individualisation, are described. Discussion: Treatment of BM has matured from a one-size-fits-all approach, to individualised treatment. Steroids are often used initially. Definitive treatment options include surgery, radiotherapy (including stereotactic radiosurgery) and systemic therapies such as chemotherapy, targeted- and immuno-therapies.

Keywords: brain; cerebral; metastases; surgery; radiotherapy.