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Radiosurgery and Immunotherapy in the Treatment of Brain Metastases.

TitleRadiosurgery and Immunotherapy in the Treatment of Brain Metastases.
Publication TypeJournal Article
Year of Publication2019
AuthorsRamakrishna R, Formenti S
JournalWorld Neurosurg
Volume130
Pagination615-622
Date Published2019 Oct
ISSN1878-8769
KeywordsBrain Neoplasms, Combined Modality Therapy, Humans, Immunologic Factors, Immunotherapy, Radiosurgery, Treatment Outcome
Abstract

Radiation therapy represents a mainstay of treatment for patients with brain metastases. Recently, the widespread adoption of immune checkpoint blockade has led to keen interest in treating cancers with checkpoint inhibitors in place of, or as an adjunct to, traditional chemotherapy. However, with the exception of melanoma, immune checkpoint blockade in solid tumors has failed to achieve significant brain control in patients with brain metastases. The possibility of combining immune checkpoint blockade with radiation for the treatment of brain and other metastases represents an exciting new strategy that is in its early stages of investigation. Success with this combinatorial strategy has the potential to result in enhanced rates of brain control, less brain exposure to radiation, and improved cognitive outcomes. In this review, we discuss the mechanisms behind this synergy, describe its limitations, and suggest ways to move the field forward.

DOI10.1016/j.wneu.2019.04.032
Alternate JournalWorld Neurosurg
PubMed ID31581411