Five-year survival rates have not increased appreciably for patients with primary and metastatic brain tumors. Nearly 17,000 patients die from primary brain tumors, whereas approximately 200,000 cases are diagnosed with brain metastasis every year in the US alone. At the same time, with improved control of systemic disease, the incidence of brain metastasis is increasing. Thus, novel approaches for improving the treatment outcome for these uniformly fatal diseases are needed urgently. In the review, we summarize the challenges in the treatment of these diseases using antiangiogenic therapies alone or in combination with radio-, chemo- and immuno-therapies. We also discuss the emerging strategies to improve the treatment outcome using both pharmacological approaches to normalize the tumor microenvironment and physical approaches (e.g., focused ultrasound) to modulate the blood-tumor-barrier, along with limitations of each approach. Finally, we offer some new avenues of future research.

中文翻译：

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为原发性和转移性脑肿瘤提供抗血管生成治疗的新兴策略。

原发性和转移性脑肿瘤患者的五年生存率并未明显提高。仅在美国，每年就有近17,000名患者死于原发性脑肿瘤，而每年约有200,000例被诊断为脑转移。同时，随着对全身性疾病的控制得到改善，脑转移的发生率也在增加。因此，迫切需要用于改善这些致命性疾病的治疗结果的新颖方法。在综述中，我们总结了单独使用抗血管生成疗法或与放射疗法，化学疗法和免疫疗法结合使用这些疗法可治疗这些疾病的挑战。我们还将讨论使用药理学方法使肿瘤微环境正常化和物理方法（例如，聚焦超声）来调节血液肿瘤屏障，以及每种方法的局限性。最后，我们提供了一些未来研究的新途径。