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Trends Cancer. 2018 Mar;4(3):176-196. doi: 10.1016/j.trecan.2018.01.003. Epub 2018 Feb 21.

The Evolving Landscape of Brain Metastasis.

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Brain Metastasis Group, Spanish National Cancer Research Center (CNIO), Melchor Fernández Almagro 3, Madrid, Spain. Electronic address:
Brain Metastasis Research Program, Burkhardt Brain Tumor and Neuro-Oncology Center, Department of Medicine, Cleveland Clinic, Neurological Institute, 9500 Euclid Avenue, 44195 Cleveland, OH, USA.
Department of Neurology, Human Oncology and Pathogenesis Program, Brain Tumor Center, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, 10065 New York, NY, USA.
Division of Hematology/Oncology, Department of Medicine; Division of Neuro-Oncology, Department of Neurology; Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Boston, 02114 Boston, MA, USA.
Department of Medicine (Medical Oncology), Yale School of Medicine, 333 Cedar Street, New Haven, CT, USA.
Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, 02215 Boston, MA, USA.
Neuro-Oncology, Department of Neurosurgery, University Hospital Lille, Salengro Hospital, Rue Emile Laine, 59037 Lille, France; Neurology, Department of Medical Oncology, Oscar Lambret Center, 59020 Lille, France; Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 1192, Villeneuve d'Ascq, France; Department of Neurology and Brain Tumor Center, University Hospital and University of Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland.
Department of Medicine I, Comprehensive Cancer Center Vienna, CNS Unit (CCC-CNS), Medical University of Vienna, Spitalgasse 23, 1090 Vienna, Austria.
Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, and Clinical Cooperation Unit Neurooncology, German Cancer Research Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.
Department of Neuro-Oncology, University Hospital Turin, Via Cherasco 15, 10126 Turin, Italy. Electronic address:


Metastasis, involving the spread of systemic cancer to the brain, results in neurologic disability and death. Current treatments are largely palliative in nature; improved therapeutic approaches represent an unmet clinical need. However, recent experimental and clinical advances challenge the bleak long-term outcome of this disease. Encompassing key recent findings in epidemiology, genetics, microenvironment, leptomeningeal disease, neurocognition, targeted therapy, immunotherapy, and prophylaxis, we review preclinical and clinical studies to provide a comprehensive picture of contemporary research and the management of secondary brain tumors.


brain metastasis; genomics; microenvironment; neurocognition; prevention; therapy

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