Xiaorui Li, Mingxi Jing , Tao Sun

The first department of Internal Medicine, Liaoning Cancer Hospital& Institute, Shenyang.

Abstract: Breast cancer brain metastases(BCBMs) represents the second mostfrequent secondary central nervous system metastases, second only to lungcancer, account for 30% of metastatic breast cancer patients. The prevalence ofBCBMs are increasing in the last decades due to the development of the imagingdiagnosis and better control of systemic disease. While radiation therapy andsurgery remain the mainstay treatment in selected patients, cytotoxic drugs andtargeted drugs have been developed for BCBMs. The traditional view is that themost chemotherapy and targeted drugs fail to achieve optimal control mainly dueto the presence of the blood-brain barrier. However, In recent years, plenty ofpreclinical and clinical trails suggest that brain metastases may be a morecomplex system including tumor cells and microenvironment of brain, variousfactors rather than blood-brain barrier limit effectiveness.This review focuseson the biology of BCBMs including astrocytes, angiogenesis, Cancer cellphenotypes and the new concept of blood-brain barrier. Moreover, systemiccytotoxic drugs and targeted therapies and their clinically relevant activitiesin BCBMs are reported and assessed.

Key words: Breast cancer  brain metastases(BCBMs)  astrocytes angiogenesis  Cancer cellphenotypes  blood-brain barrier  cytotoxic drugs  targeted drugs  cytotoxic drugs  targeted drugs.