Intracranial Metastatic Disease: Present Challenges, Future Opportunities

Intracranial metastatic disease (IMD) is a prevalent complication of cancer that significantly limits patient survival and quality of life. Over the past half-century, our understanding of the epidemiology and pathogenesis of IMD has improved and enabled the development of surveillance and treatment algorithms based on prognostic factors and tumor biomolecular characteristics. In addition to advances in surgical resection and radiation therapy, the treatment of IMD has evolved to include monoclonal antibodies and small molecule antagonists of tumor-promoting proteins or endogenous immune checkpoint inhibitors. Moreover, improvements in the sensitivity and specificity of imaging as well as the development of new serological assays to detect brain metastases promise to revolutionize IMD diagnosis. In this review, we will explore current treatment principles in patients with IMD, including the emerging role of targeted and immunotherapy in select primary cancers, and discuss potential areas for further investigation.

Automated summary

Intracranial metastatic disease (IMD) is a common complication of cancer that greatly affects patient survival and quality of life. Advances in understanding the epidemiology and pathogenesis of IMD have led to the development of surveillance and treatment algorithms based on prognostic factors and tumor biomolecular characteristics. In addition to surgical resection and radiation therapy, targeted therapy and immunotherapy have emerged as important treatment modalities for IMD. The improvement in imaging sensitivity and specificity, as well as the development of new serological assays, holds promise for revolutionizing the diagnosis of IMD.