Intracranial Malignancies: Molecular Insights and Therapeutic Advances

Dear Colleagues,

Intracranial malignancies consist of a wide spectrum of different tumor types with particular challenges to treatment and generally poor prognosis. Among the most common primary brain tumors are stage III astrocytoma and stage IV glioblastoma in adults, and medulloblastoma in pediatric patients. Other primary brain tumor types, such as meningiomas and pituitary adenomas, are oftentimes benign, but can progress to an aggressive phenotype. In comparison to these primary brain malignancies, intracranial metastases derived from systemic cancers of the lung, breast, skin, gastrointestinal tract and kidney are much more prevalent. In the United States alone, nearly 200,000 patients are newly diagnosed with such secondary brain tumors each year.

The past 30 years have seen substantial progress in brain imaging, advances in surgical technologies and intervention, availability of chemotherapies and targeted drugs, and emergence of multimodality treatment regimens that have reduced morbidity and prolonged survival of afflicted patients. Yet, most patients diagnosed with intracranial malignancies still die of the disease. For instance, median survival of all glioblastoma patients seen in routine clinical practice is about 10 months from the time of diagnosis, although otherwise healthier and younger patients (who usually are recruited for clinical trials and can withstand the rigors of intensive, multimodal therapy) may have median survival of up to two years. Among the secondary brain cancers, meningeal carcinomatosis presents with exceptionally poor prognosis; if seeded from lung cancer, median survival is a mere four months.

An increased understanding of the molecular mechanisms and pathophysiological processes is a prerequisite for the development of improved treatment options. Here, in this Special Issue, we invite contributions that represent the entire compendium from basic research to clinical implementation aimed at understanding and treating intracranial malignancies. To provide insight into the latest developments in this broad field and an outlook to where it is heading, we welcome primary scientific reports, results from clinical studies, and critical review articles.

Prof. Axel H. Schönthal
Prof. Thomas C. Chen
Guest Editors

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