Targeting the Metabolic Niche: Vulnerabilities and Opportunities in Brain Metastases

Abstract Brain metastases are the most common intracranial tumor in adults, and most arise from lung, breast, or melanoma. We propose a conceptual framework organized around three requirements for colonization, each unevenly distributed across the brain: vascular access, metabolic substrate, and escape from immune surveillance. We organize the literature around this three-axis framework and argue that metabolism, though the least exploited clinically, is where personalization may deliver the largest near-term gains. We review how lung, breast, and melanoma metastases each pair a characteristic metabolic program with characteristic anatomical distributions. Building on this, we discuss how targeted metabolic therapy, primary cancer-informed prediction, and longitudinal modeling can bring metabolism into precision brain metastasis care.

Published in Oxford Open Neuroscience. The abstract is shown as published and remains the work of its authors; read the full article at the source.

doi.org/10.1093/oons/kvag016