*August 2020*

“Brain metastases harbor distinct clinically actionable genetic alterations compared to their primary tumors and extracranial sites.”

The use of targeted therapies directed at genetic alterations specific to brain metastases is emerging as a viable precision medicine approach to treating brain metastases that have developed from solid tumors rather than using standard-of-care radiation approaches that can lead to significant and long-term cognitive decline and reduced quality of life.

According to Priscilla K. Brastianos, MD, “brain metastases harbor distinct clinically actionable genetic alterations compared to their primary tumors and extracranial sites,” she said in a presentation during the 2020 Society for Neuro-Oncology Conference on Brain Metastases.1 These distinct genetic alterations are potentially able to be targeted with genomically-targeted therapies.

Patients will often develop progressive brain metastases in the setting of stable disease outside of the brain, noted Brastianos, associate professor of medicine and director, Central Nervous System Metastasis Center, Massachusetts General Hospital. Systemic therapies may offer an opportunity to treat patients in this setting as intracranial activity has already been demonstrated with a number of newer systemic therapies, such as osimertinib (Tagrisso), alectinib (Alecensa), dabrafenib (Tafinlar), and more.

“We have a limited understanding of how brain metastases genetically evolve from their matched primary tumors,” she said. Read more.