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Metastasis to the Central Nervous System
- Source :
- Continuum (Minneap Minn)
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- Purpose of review Management of metastasis to the central nervous system (CNS) has evolved, and molecular characterization of metastatic disease is now routinely done. Targeted therapies, once few in number with limited penetration into the CNS, have multiplied in number and increased in CNS coverage. This article addresses recent advances in the evaluation and clinical management of patients with CNS metastasis. Recent findings Metastasis of cancer to the CNS can be diagnosed and characterized with novel techniques, including molecular analyses of the spinal fluid, so-called liquid biopsies. Resected parenchymal CNS metastases are now routinely subjected to genomic sequencing. For patients with CNS metastases displaying targetable mutations, a wide variety of treatment options are available, including deferral of radiation therapy in favor of a trial of an orally bioavailable targeted therapy or immunotherapy. For patients without a molecularly targetable lesion, local treatment in the form of radiation therapy, now most often stereotactic radiosurgery, is supplanting untargeted whole-brain radiation therapy. Summary Technologic advances in diagnosis and management have resulted in new diagnostic and therapeutic approaches to patients with metastasis to the CNS, with resulting improvements in progression-free and overall survival.
- Subjects :
- Central Nervous System
Oncology
medicine.medical_specialty
medicine.medical_treatment
Central nervous system
Disease
Radiosurgery
Article
Metastasis
Targeted therapy
Central Nervous System Neoplasms
Lesion
Internal medicine
medicine
Humans
Genetics (clinical)
Brain Neoplasms
business.industry
Immunotherapy
medicine.disease
Radiation therapy
medicine.anatomical_structure
Neurology (clinical)
Cranial Irradiation
medicine.symptom
business
Subjects
Details
- ISSN :
- 15386899 and 10802371
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- CONTINUUM: Lifelong Learning in Neurology
- Accession number :
- edsair.doi.dedup.....7da7b1902af2fefb9f9bc256d28ad91a