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Advances in the Management and Prognosis of Brain Metastases

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 31 August 2026 | Viewed by 2130

Special Issue Editors


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Guest Editor
Department of Radiation Oncology, Shenzhen People's Hospital (The Second Clinical Medical College of Jinan University, the First Affiliated Hospital of Southern University of Science and Technology), Shenzhen 518020, China
Interests: brain metastases; non-small cell lung cancer; radiotherapy; chemotherapy

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Guest Editor
Department of Radiation Oncology, Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital of Guangzhou Medical University, Guangzhou 510095, China
Interests: radiation oncology; brain tumors; brain metastases; tumor microenvironment; cancer therapy; immunotherapy; combination therapy

Special Issue Information

Dear Colleagues,

Brain metastases represent the most common intracranial malignancy, affecting 20–40% of adult cancer patients, with lung, breast, and melanoma accounting for the majority of cases. They carry a poor prognosis, with median survival of only 1–2 months without treatment.

Surgery benefits selected patients with solitary accessible lesions, extending median survival to 10–12 months. Radiotherapy remains a cornerstone: whole-brain radiotherapy achieves disease control but limited survival (3–6 months), whereas stereotactic radiosurgery offers local control rates of 70–90% for limited lesions. Advances in targeted therapy (e.g., EGFR, ALK, HER2 inhibitors) and immunotherapy (checkpoint inhibitors) have improved intracranial response rates (40–70%) and prolonged survival, particularly in lung cancer and melanoma.

Despite these advances, overall survival remains poor. Multidisciplinary care is critical to balancing tumor control, neurologic function, and quality of life. This Special Issue aims to expand our understanding of the latest advances in the management and prognosis of brain metastases, with a particular focus on multimodality approaches.

Dr. Guixiang Liao
Dr. Muhammad Khan
Guest Editors

Manuscript Submission Information

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Keywords

  • immunotherapy
  • target therapy
  • stereotactic radiotherapy
  • prognosis
  • quality of life

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Published Papers (2 papers)

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Research

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12 pages, 827 KB  
Article
Prognostic Factors for Intracranial Progression in Her-2-Overexpressing Breast Cancer Patients with Brain Metastases as Primary Relapse Site—Real-Life Data
by Agnieszka Majewska, Tomasz Byrski and Michał Falco
Cancers 2026, 18(10), 1659; https://doi.org/10.3390/cancers18101659 - 20 May 2026
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Abstract
Background: Her-2 positive breast cancer is characterised by a high risk of metastases to the central nervous system, which significantly affects prognosis. The aim of this study was to analyse risk factors and treatment outcomes for brain metastases diagnosed at the time of [...] Read more.
Background: Her-2 positive breast cancer is characterised by a high risk of metastases to the central nervous system, which significantly affects prognosis. The aim of this study was to analyse risk factors and treatment outcomes for brain metastases diagnosed at the time of first progression. Materials and Methods: A retrospective analysis was conducted on 1226 patients treated between 2010 and 2022. Distant metastases were diagnosed in 186 (15.7%) patients, including 48 (25.8%) with BM at the time of first progression. The impact of clinical factors and treatment on overall survival (OS) and intracranial progression-free survival (PFS) was analysed. Results: Patients with BM were significantly younger than other patients with distant metastases (mean 52.4 years vs. 61.1 years, p = 0.0001). The most significant prognostic factor for OS was the number of intracranial lesions (p = 0.0004). OS did not differ significantly depending on the use of local therapy (local therapy vs. whole-brain radiotherapy) or systemic therapy (observation vs. chemotherapy vs. anti-Her2 treatment). Conclusions: The number of brain metastases remains a key prognostic factor and should be taken into account in therapeutic decision-making, which highlights the importance of early identification of high-risk patients and the number of intracranial lesions in treatment selection. Full article
(This article belongs to the Special Issue Advances in the Management and Prognosis of Brain Metastases)
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Review

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16 pages, 1979 KB  
Review
Triple-Negative Breast Cancer Brain Metastasis: A Comprehensive Review of Epidemiology, Molecular Pathobiology, and Therapeutic Frontiers
by Hongli Yang, Yang Zhao, Yue Wang, Xiaoyuan Ma, Jinmei Ling, Xianyi Zeng, Zihuang Li and Guixiang Liao
Cancers 2026, 18(7), 1179; https://doi.org/10.3390/cancers18071179 - 7 Apr 2026
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Abstract
Triple-negative breast cancer (TNBC) is associated with a high risk of brain metastases (BMs). Although systemic therapies have improved extracranial disease control, the central nervous system (CNS) remains less accessible to numerous agents. As a result, this limited drug penetration makes brain metastases [...] Read more.
Triple-negative breast cancer (TNBC) is associated with a high risk of brain metastases (BMs). Although systemic therapies have improved extracranial disease control, the central nervous system (CNS) remains less accessible to numerous agents. As a result, this limited drug penetration makes brain metastases (BMs) remain common in TNBC, which are a leading cause of serious symptoms. This review summarizes recent key advances in triple-negative breast cancer brain metastases (TNBC-BMs), including epidemiology, prognostic stratification, biological mechanisms of CNS tropism and treatment resistance, and evolving management strategies. We discuss potential mechanisms of brain colonization, including the FOXC1-CXCR4 axis, ST6GALNAC5-related interactions with the blood–brain barrier (BBB), and the bidirectional crosstalk between metastatic cells and the brain microenvironment, particularly astrocytes and microglia. Furthermore, we evaluate the evolving clinical management, emphasizing the transition from whole-brain radiotherapy (WBRT) toward more selective local approaches such as stereotactic radiotherapy (SRS) and hippocampal sparing techniques. Concurrently, we examine the integration of CNS active systemic therapy across specific molecular subsets. This review systematically distinguishes standard-of-care interventions from investigational strategies, ultimately underscoring critical evidence gaps within the TNBC-BM landscape. Full article
(This article belongs to the Special Issue Advances in the Management and Prognosis of Brain Metastases)
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