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An Introduction to Brain Metastasis

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Central Nervous System Metastasis, the Biological Basis and Clinical Considerations

Part of the book series: Cancer Metastasis - Biology and Treatment ((CMBT,volume 18))

Abstract

The incidence of brain metastasis is increasing. In fact, the incidence of brain metastasis outnumbers that of primary brain tumors by a factor of ten and is by far the most common neurologic complication of cancer. The reasons underlying the increasing incidence of brain metastasis are unclear, but may be associated with increased patient survival, improved imaging techniques, and greater awareness of the disease. With the increasing incidence, however, it is apparent that our understanding of the biology and epidemiology of brain metastasis is limited. Although most solid primary tumors can develop metastatic disease in the brain, approximately 80% of all brain metastases arise from adenocarcinomas of lung (50–60%) and breast (15–20%) and from malignant melanoma (5–10%). Brain metastases can develop from renal or colon cancers and other solid tumors but do so less frequently than metastases from the lung or breast. Within the brain, metastatic cancer cells can seed and grow in the brain parenchyma and the leptomeninges. Risk factors associated with the development of brain metastasis may vary according to origin of the primary cancer, which also often dictates the clinical experience and prognosis for a patient with a brain metastasis. Recently, a Graded Prognostic Assessment tool was developed to aid in treatment decisions and brain metastasis specific clinical trial strategies. Historically, patients with brain metastases have been excluded from clinical trials that enrolled metastatic cancer patients. Regardless of the origin of the primary cancer, prognosis is poor for patients who develop brain metastases, with median overall survival ranging from 4.8 to 13.8 months across all primary tumor histologies.

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Authors and Affiliations

  1. National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Diane Palmieri Ph.D.

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  1. Diane Palmieri Ph.D.
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Correspondence to Diane Palmieri Ph.D. .

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  1. , Laboratory of Molecular Pharmacology, National Cancer Institute, Convent Drive Building 3, Bethesda, 20892, Maryland, USA

    Diane Palmieri

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Palmieri, D. (2012). An Introduction to Brain Metastasis. In: Palmieri, D. (eds) Central Nervous System Metastasis, the Biological Basis and Clinical Considerations. Cancer Metastasis - Biology and Treatment, vol 18. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-5291-7_1

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