Novel Pharmaceutical Strategies for Targeting Brain Metastases

Brain metastases (BM) are a frequent and feared complication of many solid tumors. Their increasing incidence makes them a major therapeutic challenge. BM are associated with poor prognosis, substantial morbidity, and a significant deterioration in quality of life, highlighting the urgent need for more effective and innovative treatment strategies. The management of brain metastases remains particularly complex due to the limited access of therapeutic agents to the central nervous system, primarily because of the blood-brain barrier (BBB).
This physiological barrier restricts the passage of many molecules, thereby compromising their efficacy within the brain compartment. Moreover, the heterogeneity of brain metastases across different tumor types further complicates treatment decisions, requiring highly individualized approaches. At the same time, personalized medicine approaches are generating growing interest, promoting the development of targeted therapies and paving the way for tailored treatment strategies. Emerging technologies, including nanomedicine, focused ultrasound, and novel drug delivery platforms, are now being explored to overcome these barriers and enhance therapeutic concentrations in the brain. In the context of brain metastases, these approaches face two major challenges: crossing the BBB and maintaining therapeutically effective concentrations within the central nervous system.
This Research Topic aims to explore original and emerging approaches to the treatment of brain metastases, with a focus on the specific challenges of this localization and recent advances in innovative delivery systems and other strategies to optimize brain pharmacology. Please note: Brain metastases in children are considered out-of-scope for this Research Topic, which focuses on adult populations. It seeks to provide a comprehensive overview of the evolving therapeutic landscape, including clinical trial results, translational research, and multidisciplinary management strategies, with the ultimate goal of better meeting the complex needs of patients affected by BM.
Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases, which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo) are not suitable for publication in this journal.