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Emerging Immunotherapies in the Treatment of Brain Metastases |
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| Authors: | Edwin Nieblas-Bedolla Naema Nayyar Mohini Singh Ryan J Sullivan Priscilla K Brastianos |
| Affiliation: | 1. University of Washington School of Medicine, Seattle, Washington, USA;2. Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA
Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, Massachusetts, USA Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA;3. Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA;4. Cancer Center, Massachusetts General Hospital, Boston, Massachusetts, USA Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachustets, USA;5. Broad Institute of Massachusetts Institute of Technology and Harvard, Boston, Massachusetts, USA |
| Abstract: | Brain metastases account for considerable morbidity and mortality in patients with cancer. Despite increasing prevalence, limited therapeutic options exist. Recent advances in our understanding of the molecular and cellular underpinnings of the tumor immune microenvironment and the immune evasive mechanisms employed by tumor cells have shed light on how immunotherapies may provide therapeutic benefit to patients. The development and evolution of immunotherapy continue to show promise for the treatment of brain metastases. Positive outcomes have been observed in several studies evaluating the efficacy and safety of these treatments. However, many challenges persist in the application of immunotherapies to brain metastases. This review discusses the potential benefits and challenges in the development and use of checkpoint inhibitors, chimeric antigen receptor T‐cell therapy, and oncolytic viruses for the treatment of brain metastases. Future studies are necessary to further evaluate and assess the potential use of each of these therapies in this setting. As we gain more knowledge regarding the role immunotherapies may play in the treatment of brain metastases, it is important to consider how these treatments may guide clinical decision making for clinicians and the impact they may have on patients.Implications for PracticeImmunotherapies have produced clinically significant outcomes in early clinical trials evaluating patients with brain metastases or demonstrated promising results in preclinical models. Checkpoint inhibitors have been the most common immunotherapy studied to date in the setting of brain metastases, but novel approaches that can harness the immune system to contain and eliminate cancer cells are currently under investigation and may soon become more common in the clinical setting. An understanding of these evolving therapies may be useful in determining how the future management and treatment of brain metastases among patients with cancer will continue to advance. |
| Keywords: | Brain metastasis Immunotherapy |
