Brain metastasis, which commonly arises in patients with lung cancer, breast cancer and melanoma, is associated with poor survival outcomes and poses distinct clinical challenges. The brain microenvironment, with its unique cell types, anatomical structures, metabolic constraints and immune environment, differs drastically from microenvironments of extracranial lesions, imposing a distinct and profound selective pressure on tumour cells that, in turn, shapes the metastatic process and therapeutic responses. Accordingly, the study of brain metastasis could uncover new therapeutic targets and identify novel treatment approaches to address the unmet clinical need. Moreover, such efforts could provide insight into the biology of primary brain tumours, which face similar challenges to brain metastases of extracranial origin, and vice versa. However, the paucity of robust preclinical models of brain metastasis has severely limited such investigations, underscoring the importance of developing improved experimental models that holistically encompass the metastatic cascade and/or brain microenvironment. In this Viewpoint, we asked four leading experts to provide their opinions on these important aspects of brain metastasis biology and management.

中文翻译：

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脑转移。

脑转移通常发生在肺癌，乳腺癌和黑色素瘤患者中，与不良的生存结果相关，并提出了独特的临床挑战。大脑微环境具有独特的细胞类型，解剖结构，代谢限制和免疫环境，与颅外病变的微环境截然不同，对肿瘤细胞施加了独特而深刻的选择性压力，进而改变了转移过程和治疗反应。因此，对脑转移的研究可能会发现新的治疗目标，并确定新的治疗方法来解决未满足的临床需求。此外，这种努力可以提供对原发性脑肿瘤生物学的深刻见解，原发性脑肿瘤面临与颅外起源的脑转移瘤相似的挑战，反之亦然。然而，缺乏可靠的脑转移临床前模型严重限制了此类研究，从而强调了开发改进的实验模型的重要性，该模型全面涵盖了转移级联和/或脑微环境。在此观点中，我们请四位主要专家就脑转移生物学和管理的这些重要方面提供他们的意见。