Multidisciplinary patient-centered management of brain metastases and future directions

Joshua D. Palmer, Daniel M. Trifiletti, Vinai Gondi, Michael Chan, Giuseppe Minniti, Chad G. Rusthoven, Steven E. Schild, Mark V. Mishra, Joseph Bovi, Nicole Williams, Maryam Lustberg, Paul D. Brown, Ganesh Rao, David Roberge

Research output: Contribution to journalArticlepeer-review


The incidence of brain metastasis is increasing as improvements in systemic therapy lead to increased survival. This provides new and challenging clinical decisions for patients who are trying to balance the risk of recurrence or progression with treatment-related side effects, and it requires appropriate management strategies from multidisciplinary teams. Improvements in prognostic assessment and systemic therapy with increasing activity in the brain allow for individualized care to better guide the use of local therapies and/or systemic therapy. Here, we review the current landscape of brain-directed therapy for the treatment of brain metastasis in the context of recent improved systemic treatment options. We also discuss emerging treatment strategies including targeted therapies for patients with actionable mutations, immunotherapy, modern whole-brain radiation therapy, radiosurgery, surgery, and clinical trials.

Original languageEnglish (US)
Article numbervdaa034
JournalNeuro-Oncology Advances
Issue number1
StatePublished - Jan 1 2020


  • brain metastasis
  • radiosurgery
  • surgery
  • systemic therapy
  • treatment overview

ASJC Scopus subject areas

  • Clinical Neurology
  • Oncology
  • Surgery


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