Immunotherapy in patients with brain metastasis: advances and challenges for the treatment and the application of circulating biomarkers

Sep 24, 2026

Uploaded by Franzy

Central nervous system brain metastases are a common and devastating complication across solid tumors such as lung cancer, breast cancer, and melanoma, contributing to high mortality and impaired quality of life. Precision medicine and immunotherapy have improved outcomes, while liquid biopsy enables real-time monitoring and access to molecular prognostic and predictive information from blood and other fluids. This review synthesizes clinical trial evidence for immunotherapy in brain-metastasis patients and evaluates how circulating biomarkers may enhance efficacy and reduce toxicity in this subgroup.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Clinical challenge

Treatment mainstays and limitations

Rationale for biomarkers and monitoring

TYPE Review PUBLISHED 03 November 2023 DOI 10.3389/fimmu.2023.1221113 OPEN ACCESS EDITED BY Xabier Mielgo-Rubio, Hospital Universitario Fundacio´n Alcorco´n, Spain REVIEWED BY Alessia Pellerino, University Hospital of the City of Health and Science of Turin, Italy Jack Wadden, University of Michigan, United States *CORRESPONDENCE E. M. Brozos-V´azquez [elenambrozosv@hotmail.com](elenambrozosv@hotmail.com) [R. Lo](R. Lo)´ pez-Lo´pez [rafael.lopez.lopez@sergas.es](rafael.lopez.lopez@sergas.es) RECEIVED 11 May 2023 ACCEPTED 17 October 2023 PUBLISHED 03 November 2023 CITATION Brozos-V´azquez EM, Rodrguez-Lo´pez C, Cortegoso-Mosquera A, Lo´ pez-Landrove S, Muinelo-Romay L, Garca-Gonz´alez J, Lo´ pez-Lo´ pez R and Leo´n-Mateos L (2023) Immunotherapy inpatients with brain metastasis: advancesand challenges for the treatment and the application of circulating biomarkers. Front. Immunol. 14:1221113 . doi: 10.3389/fimmu.2023.1221113 COPYRIGHT © 2023 Brozos-V´azquez, Rodrguez-Lo´pez, Cortegoso-Mosquera, Lo´ pez-Landrove, Muinelo-Romay, Garca-Gonz´alez, Lo´ pez-Lo´ pez and Leo´ n-Mateos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Immunotherapy in patients with brain metastasis: advances and challenges for the treatment and the application of circulating biomarkers E. M. Brozos-V´azquez 1,2,3,4*, C. Rodr ´ıguez-Lo´ pez 1,3,4, A. Cortegoso-Mosquera 1,3,4, S. Lo´ pez-Landrove3, L. Muinelo-Romay 3,4, J. Garc ´ıa-Gonz´alez 1,3,4, R. Lo´ pez-Lo´ pez 1,3,4* and L. Leo´ n-Mateos 1,3,4 1 Medical Oncology Department, Complexo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain, 2 Medical Oncology Department, Complexo Hospitalario Universitario de A Coruña, Santiago de Compostela, Spain, 3ONCOMET, Instituto de Investigacio´n Sanitaria de Santiago, Santiago de Compostela, Spain, 4CIBERONC, Madrid, Spain The central nervous system (CNS) is one of the most frequent metastatic sites of various cancers, including lung cancer, breast cancer and melanoma. The development of brain metastases requires a speciﬁc therapeutic approach and is associated with high mortality and morbidity in cancer patients. Advances in precision medicine and the introduction in recent years of new drugs, such as immunotherapy, have made it possible to improve the prognosis of these patients by improving survival and quality of life. New diagnostic techniques such as liquid biopsy allow real-time monitoring of tumor evolution, providing molecular information on prognostic and predictive biomarkers of response to treatment in blood or other ﬂuids. In this review, we perform an exhaustive update of the clinical trials that demonstrate the utility of immunotherapy inpatients with brain metastases and the potential of circulating biomarkers to improving the results of efﬁcacy and toxicity in this subgroup of patients. KEYWORDS solid tumors, brain metastasis, biomarkers, immunotherapy, liquid biopsy 1 Clinical challenge The brain is one of the most frequent sites of metastases from some types of solid tumors, such as lung, breast cancers and melanoma. The presence of disease in the brain represents a dismal prognosis and devastating complications for the quality of life of oncological patients and can lead to a different evolution in relation to the histological and molecular type, and clinical characteristics of the tumor. Recent advances in Oncology have improved survival Frontiers in Immunology 01 [frontiersin.org](frontiersin.org) rates, with the incidence of brain metasta

FAQs

Why do brain metastases require a specific therapeutic approach?

Brain metastases have high mortality and morbidity and often lead to devastating quality-of-life complications, making management distinct from systemic disease.

What role do liquid biopsy techniques play in this setting?

Liquid biopsy enables real-time monitoring of tumor evolution and provides molecular information for prognostic and predictive biomarkers related to treatment response.

How do circulating biomarkers relate to treatment outcomes?

The review focuses on the potential of circulating biomarkers to improve efficacy and toxicity results in patients receiving immunotherapy for brain metastases.

Sep 24, 2026

Uploaded by Franzy