Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted Agents
Brain metastases (BMs) are the most common intracranial tumours in adults and occur up to 3–10 times more frequently than primary brain tumours. BMs may be the cause of the neurological presenting symptoms in patients with otherwise previously undiagnosed cancer. In up to 15% of patients with BMs, t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-11-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/12/11/3350 |
| _version_ | 1797548151195828224 |
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| author | Roberta Balestrino Roberta Rudà Riccardo Soffietti |
| author_facet | Roberta Balestrino Roberta Rudà Riccardo Soffietti |
| author_sort | Roberta Balestrino |
| collection | DOAJ |
| description | Brain metastases (BMs) are the most common intracranial tumours in adults and occur up to 3–10 times more frequently than primary brain tumours. BMs may be the cause of the neurological presenting symptoms in patients with otherwise previously undiagnosed cancer. In up to 15% of patients with BMs, the primary tumour cannot be identified. These cases are known as BM of cancer of unknown primary (CUP) (BM-CUP). CUP has an early and aggressive metastatic spread, poor response to chemotherapy, and poor prognosis. The pathogenesis of CUP seems to be characterized by a specific underlying pro-metastatic signature. The understanding of BM-CUP, despite its relative frequency and unfavourable outcome, is still incomplete and clear indications on management are missing. Advances in diagnostic tools, molecular characterization, and target therapy have shifted the paradigm in the approach to metastasis from CUP: while earlier studies stressed the importance of finding the primary tumour and deciding on treatment based on the primary diagnosis, most recent studies focus on the importance of identifying targetable molecular markers in the metastasis itself. The aim of this review is to summarize current evidence on BM-CUP, from the diagnosis and pathogenesis to the treatment, with a focus on available studies and ongoing clinical trials. |
| first_indexed | 2024-03-10T14:54:23Z |
| format | Article |
| id | doaj.art-f0b6e103721d46b8bf683fd309e86c37 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T14:54:23Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-f0b6e103721d46b8bf683fd309e86c372023-11-20T20:43:37ZengMDPI AGCancers2072-66942020-11-011211335010.3390/cancers12113350Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted AgentsRoberta Balestrino0Roberta Rudà1Riccardo Soffietti2Department of Neuroscience, University of Turin, Via Cherasco 15, 10121 Turin, ItalyDepartment of Neurology, Castelfranco Veneto/Treviso Hospital, Via dei Carpani, 16/Z, 31033 Castelfranco Veneto, ItalyDepartment of Neuro-Oncology, University of Turin, Via Cherasco 15, 10121 Turin, ItalyBrain metastases (BMs) are the most common intracranial tumours in adults and occur up to 3–10 times more frequently than primary brain tumours. BMs may be the cause of the neurological presenting symptoms in patients with otherwise previously undiagnosed cancer. In up to 15% of patients with BMs, the primary tumour cannot be identified. These cases are known as BM of cancer of unknown primary (CUP) (BM-CUP). CUP has an early and aggressive metastatic spread, poor response to chemotherapy, and poor prognosis. The pathogenesis of CUP seems to be characterized by a specific underlying pro-metastatic signature. The understanding of BM-CUP, despite its relative frequency and unfavourable outcome, is still incomplete and clear indications on management are missing. Advances in diagnostic tools, molecular characterization, and target therapy have shifted the paradigm in the approach to metastasis from CUP: while earlier studies stressed the importance of finding the primary tumour and deciding on treatment based on the primary diagnosis, most recent studies focus on the importance of identifying targetable molecular markers in the metastasis itself. The aim of this review is to summarize current evidence on BM-CUP, from the diagnosis and pathogenesis to the treatment, with a focus on available studies and ongoing clinical trials.https://www.mdpi.com/2072-6694/12/11/3350brain metastasiscancer of unknown primarytarget therapymolecular markersgene expression profilingneuro-oncology |
| spellingShingle | Roberta Balestrino Roberta Rudà Riccardo Soffietti Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted Agents Cancers brain metastasis cancer of unknown primary target therapy molecular markers gene expression profiling neuro-oncology |
| title | Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted Agents |
| title_full | Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted Agents |
| title_fullStr | Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted Agents |
| title_full_unstemmed | Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted Agents |
| title_short | Brain Metastasis from Unknown Primary Tumour: Moving from Old Retrospective Studies to Clinical Trials on Targeted Agents |
| title_sort | brain metastasis from unknown primary tumour moving from old retrospective studies to clinical trials on targeted agents |
| topic | brain metastasis cancer of unknown primary target therapy molecular markers gene expression profiling neuro-oncology |
| url | https://www.mdpi.com/2072-6694/12/11/3350 |
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