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Published on: August 2, 2022
Emerging and investigational targeted chemotherapy and immunotherapy agents for metastatic brain tumors
J Tanner McMahon1, Razan R Faraj1, David Cory Adamson1,2
1Department of Neurosurgery, Emory University , Atlanta, GA, USA.
Introduction:
Metastases to the central nervous system are the most common cause of malignant intracranial tumors in adults. Current standard of care includes surgery and radiation, but overall survival remains poor. A range of systemic therapies are emerging as promising treatment options for these patients.
Areas Covered:
This study reviews novel drug regimens that are under investigation in phase 1 and 2 clinical trials. To identify relevant therapies under clinical investigation, a search was performed on http://clinicaltrials.gov and Pubmed with the keywords brain metastasis, Phase I clinical trial, and Phase II clinical trial from 2016 to 2020. The authors detail the mechanisms of action of all trial agents, outline evidence for their utility, and summarize the current state of the field.
Expert Opinion:
Current advancements in the medical management of brain metastases can be categorized into targeted therapies, methods of overcoming treatment resistance, novel combinations of therapies, and modulation of the tumor microenvironment with a specific focus on immunotherapy. Each of these realms holds great promise for the field going forward. A more streamlined structure for enrollment into clinical trials will be a crucial step in accelerating progress in this area.
Insights
Novel systemic therapies show promise for treating brain metastases, the most common cause of malignant brain tumors. Ongoing clinical trials are exploring targeted treatments, immunotherapy, and combination strategies to improve patient survival.
Area of Science:
- Neuro-oncology
- Translational medicine
- Clinical pharmacology
Background:
- Central nervous system metastases are the most frequent cause of malignant intracranial tumors in adults.
- Current treatments (surgery, radiation) offer limited survival benefits.
- Emerging systemic therapies present new treatment avenues.
Purpose of the Study:
- To review novel systemic drug regimens for brain metastases.
- To assess therapies currently in Phase I and II clinical trials.
- To summarize the current landscape of brain metastasis treatment.
Main Methods:
- Systematic literature search of clinicaltrials.gov and PubMed (2016-2020).
- Keywords: brain metastasis, Phase I clinical trial, Phase II clinical trial.
- Analysis of drug mechanisms, efficacy evidence, and field status.
Main Results:
- Advancements include targeted therapies, resistance-overcoming strategies, novel combinations, and immunotherapy.
- These approaches aim to improve outcomes for patients with brain metastases.
- Immunotherapy and tumor microenvironment modulation are key areas of focus.
Conclusions:
- Targeted therapies, combination treatments, and immunotherapy offer significant promise.
- Overcoming treatment resistance is critical for improving patient survival.
- Streamlined clinical trial enrollment is essential for accelerating progress.
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