Rekha Swamy - Department of Neurosurgery
As time has progressed, it has become apparent that neurosurgery has transformed when it comes to the care of patients battling life-threatening cancer. In the pharmacological world, countless molecular inhibitors have been formulated to alter signal transduction pathways preventing unwanted cell proliferation or cerebral cancer. In addition to targeted and local therapies, numerous surgical-based solutions can address central nervous system (CNS) metastasis. With that being said, the viability of the surgical option is dependent on the number of metastatic lesions that are resected. Many of these surgical procedures include the removal of masses, tumors, and abnormal tissue growth. However, there are various methods to approach the treatment of CNS metastasis. These treatments include doing a controlled schedule of the study drug, whether that be an inhibitor or other therapeutic advancements, along with surgical intervention to ensure the best neuro-oncological outcomes for patients with brain metastasis.
By studying the metastatic brain tumor patient outcomes with therapeutic drugs prior to surgery, physicians can gauge the effectiveness of the pharmacological agent which may highlight “window-of-opportunity trials.” There is a prevalent idea that neurosurgical care is the gold standard in addressing brain metastasis, however, this paper looks at the problem one step further and investigates whether it would be worthwhile to employ targeted therapeutic agents. Within this exploration, the concepts of ideal timing and sequence in which surgery and other treatments such as stereotactic radiotherapy, immunotherapy, steroids, or chemotherapy were emphasized. This study aims to encourage the incorporation of alternative treatments along with oncological surgery to further increase the successful removal and reduction of cancer in patients with brain metastasis.
References:
Peruzzi P, Valdes PQ, Aghi MK, Berger M, Chiocca EA, Golby AJ. The Evolving Role of Neurosurgical Intervention for Central Nervous System Tumors. Hematol Oncol Clin North Am. 2022 Feb;36(1):63-75. doi: 10.1016/j.hoc.2021.08.003. Epub 2021 Sep 23. PMID: 34565649.
Edited By: Firas Batrash, Editor-in-Chief
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