Microenvironmental Response and New Treatment Modalities in Brain Metastasis

HONG Yanzhe^1,2, MAO Yinghui^1,2, KOU Lanwen^1,3, YI Xueying¹, CHI Yudan^1,2*

(¹Institute for Translational Brain Research, MOE Frontiers Center for Brain Science, State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai 200032, China; ²Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai 200040, China; ³School of Mathematical Sciences, Tongji University, Shanghai Intelligent Computing Frontier Science Research Base, Shanghai 200092, China)

Abstract:

Brain metastasis, the most common type of intracranial neoplasm originating outside the CNS (central nervous system) is the major cause of morbidity and mortality in cancer patients. Recent advances in the compartment of the CNS microenvironment has attracted wide attention of neuro-oncologists and scientists. Different from the microenvironmental setting of extracranial lesions, the CNS environment has unique characterizations such as cell types, nutritional constraints, and a specific immune environment. Bloodbrone cancer cells invade into the CNS barriers and finalize to the formation of secondary tumor, undergoing the sequential processes with dormancy, colonization, proliferation, and local deposition. The interaction and ecosystem between the CNS microenvironment and cancers cells at different stages underlie the evolutionary basis of brain metastasis. The review disscusses recent progress that is enabling pathological mechanism, tumor microenvironment, and therapeutic advances in treating both micro- and macrometastases. These studies reveal both the nature and driver of brain metastases to promote the precision treatment and improve patient outcomes.

CSTR: 32200.14.cjcb.2022.04.0003