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Related Concept Videos

Treatment Resistant Cancers02:56

Treatment Resistant Cancers

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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Related Experiment Video

Updated: Oct 9, 2025

Modeling Brain Metastasis by Internal Carotid Artery Injection of Cancer Cells
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Treatment for Brain Metastases: ASCO-SNO-ASTRO Guideline.

Michael A Vogelbaum1, Paul D Brown2, Hans Messersmith3

  • 1Moffit Cancer Center, Tampa, FL.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
|December 21, 2021
PubMed
Summary

This guideline offers recommendations for treating brain metastases from solid tumors. Surgery is viable, and local therapy is advised for symptomatic or asymptomatic patients, with specific options for stereotactic radiosurgery.

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Area of Science:

  • Neuro-oncology
  • Radiation Oncology
  • Surgical Oncology

Background:

  • Brain metastases represent a significant challenge in solid tumor management.
  • Optimal therapeutic strategies are crucial for improving patient outcomes and quality of life.

Purpose of the Study:

  • To provide evidence-based guidance for clinicians managing patients with brain metastases.
  • To establish recommendations for therapy in brain metastases from solid tumors.

Main Methods:

  • Systematic literature review of randomized trials published from 2008 onwards.
  • Convening of an Expert Panel by ASCO to synthesize evidence.

Main Results:

  • Thirty-two randomized trials formed the primary evidence base.
  • Surgery is a reasonable option, particularly for patients with large tumors and mass effect.
  • Local therapy is recommended for symptomatic brain metastases and generally for asymptomatic cases, with specific regimens for non-small-cell lung cancer, breast cancer, and melanoma.

Conclusions:

  • Stereotactic radiosurgery (SRS) is recommended for specific patient groups with asymptomatic brain metastases.
  • Memantine and hippocampal avoidance should be considered for patients receiving whole brain radiation therapy.
  • Certain patient groups with asymptomatic brain metastases and no systemic therapy options do not benefit from radiation therapy.