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Schulz C, Proescholdt M, Schmidt NO, Steger F, Heudobler D. [Brain metastases]. Pneumologie 2024; 78:578-589. [PMID: 38266745 DOI: 10.1055/a-2238-1840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Cerebral metastases in patients with metastatic lung cancer are found in more than 30% of patients at baseline and manifest themselves in two out of three patients during disease evolution. For a long time, the cerebral manifestation of the disease was classified as prognostically unfavorable and hence such patients were regularly excluded from therapy studies. In the context of targeted molecular therapy strategies and established immuno-oncological systemic therapies, the blood-brain barrier no longer represents an insurmountable barrier. However, the treatment of brain metastases requires decision making in a multidisciplinary team within dedicated lung cancer and/or oncology centers. The differentiated treatment decision is based on the number, size and location of the brain metastases, neurology and general condition, comorbidities, potential life expectancy and the patient's wishes, but also tumor biology including molecular targets, extra-cranial tumor burden and availability of a CNS-effective therapy. Systemic therapies as well as neurosurgical and radiotherapeutic concepts are now often combined for optimized and prognosis-improving therapeutic strategies.
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Affiliation(s)
- Christian Schulz
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Martin Proescholdt
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Nils Ole Schmidt
- Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Felix Steger
- Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - Daniel Heudobler
- Klinik und Poliklinik für Innere Medizin III, Universitätsklinikum Regensburg, Regensburg, Deutschland
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Fantin J, Toutain J, Pérès EA, Bernay B, Mehani SM, Helaine C, Bourgeois M, Brunaud C, Chazalviel L, Pontin J, Corroyer-Dulmont A, Valable S, Cherel M, Bernaudin M. Assessment of hypoxia and oxidative-related changes in a lung-derived brain metastasis model by [ 64Cu][Cu(ATSM)] PET and proteomic studies. EJNMMI Res 2023; 13:102. [PMID: 38006431 PMCID: PMC10676347 DOI: 10.1186/s13550-023-01052-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Brain metastases (BM) are the most frequent malignant brain tumors. The aim of this study was to characterize the tumor microenvironment (TME) of BM and particularly hypoxia and redox state, known to play a role in tumor growth and treatment resistance with multimodal PET and MRI imaging, immunohistochemical and proteomic approaches in a human lung cancer (H2030-BrM3)-derived BM model in rats. RESULTS First, in vitro studies confirmed that H2030-BrM3 cells respond to hypoxia with increasing expression of HIF-1, HIF-2 and their target genes. Proteomic analyses revealed, among expression changes, proteins associated with metabolism, oxidative stress, metal response and hypoxia signaling in particular in cortical BM. [64Cu][Cu(ATSM)] PET revealed a significant uptake by cortical BM (p < 0.01), while no uptake is observed in striatal BM 23 days after tumor implantation. Pimonidazole, HIF-1α, HIF-2α, CA-IX as well as GFAP, CTR1 and DMT1 immunostainings are positive in both BM. CONCLUSION Overall, [64Cu][Cu(ATSM)] imaging and proteomic results showed the presence of hypoxia and protein expression changes linked to hypoxia and oxidative stress in BM, which are more pronounced in cortical BM compared to striatal BM. Moreover, it emphasized the interest of [64Cu][Cu(ATSM)] PET to characterize TME of BM and depict inter-metastasis heterogeneity that could be useful to guide treatments.
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Affiliation(s)
- Jade Fantin
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Jérôme Toutain
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Elodie A Pérès
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Benoit Bernay
- Université de Caen Normandie, Normandie Univ., US EMerode, Plateforme Proteogen, F-14000, Caen, France
| | - Sarina Maya Mehani
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Charly Helaine
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Mickael Bourgeois
- CRCI2NA, INSERM UMR1307, CNRS-ERL6075, Université d'Angers, Université de Nantes, F-44000, Nantes, France
- GIP ARRONAX, F-44800, Saint-Herblain, France
| | - Carole Brunaud
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Laurent Chazalviel
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Julien Pontin
- Université de Caen Normandie, Normandie Univ., US EMerode, Plateforme Proteogen, F-14000, Caen, France
| | - Aurélien Corroyer-Dulmont
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
- Medical Physics Department, CLCC François Baclesse, F-14000, Caen, France
| | - Samuel Valable
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France
| | - Michel Cherel
- CRCI2NA, INSERM UMR1307, CNRS-ERL6075, Université d'Angers, Université de Nantes, F-44000, Nantes, France
- GIP ARRONAX, F-44800, Saint-Herblain, France
| | - Myriam Bernaudin
- Université de Caen Normandie, CNRS, Normandie Univ., ISTCT UMR6030, GIP CYCERON, F-14000, Caen, France.
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