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declarative memory and even to decreased hippocampal brain metastases. New developments in this field could
volumes. [104] The severity of memory impairment is potentially further expand the treatment spectrum. [108-111]
correlated to dose and duration of use. [105]
For meeting these challenges, interdisciplinary and
Primary prevention strategies might include the integrative research strategies must combine clinical
implementation of hippocampal-sparing whole brain investigation, neurological workup, quality of life
radiation therapy, prophylactic use of the N-methyl-D- assessments, neurocognitive testing, imaging, and
aspartate receptor modulator memantine, or blocking the histological and molecular profiling of tumor tissue to
RAAS cascade. Assessment and treatment of depression is design individualized treatment strategies tailored to
an important strategy, including appropriate pharmaceutical patients with CNS metastases. Only then can the full
or psychological treatments. potential of precision therapeutic approaches be exploited
for improving outcomes for our patients.
FUTURE PERSPECTIVES
Financial support and sponsorship
With increasing incidence of CNS metastases, an Intramural Funding of the Center for Personalized Medicine
improvement of existing treatment strategies is (Demonstratorprojekt “CNSMet”).
urgently needed. Important steps for meeting this
important epidemiological challenge include systematic Conflicts of interest
interdisciplinary multiprofessional treatment teams, There are no conflicts of interest.
thorough biosampling and biobank studies for the
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Journal of Cancer Metastasis and Treatment ¦ Volume 2 ¦ May 20, 2016 ¦ 171