{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T19:24:26Z","timestamp":1792265066720,"version":"4.4.0"},"reference-count":92,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am Soc Clin Oncol Educ Book"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p> The management of brain metastases, a potentially devastating complication of advanced cancers, has become increasingly complex with advancements in local and systemic therapies. Improved outcomes and extended survival for patients with metastatic solid tumors have led to a surge in the prevalence and possibly incidence of brain metastases, affecting up to 40% of individuals with solid tumors. Enhanced imaging technologies contribute to more accurate and early detection, shaping the understanding of the intricate landscape of this condition. Traditionally, surgery and radiation stood as the mainstays of treatment because of the limited efficacy of systemic therapies within the brain. However, emerging clinical data, particularly in melanoma, lung, and breast cancers, reveal promising results with novel systemic treatments such as immunotherapy and targeted therapies. Despite the historical exclusion of patients with active brain metastases from clinical trials, a shift is occurring toward a more inclusive approach. This chapter delves into the multifaceted challenges associated with managing brain metastases, with a focus on the evolving landscape of systemic approaches as well as the intricacies of shared decision making, providing a comprehensive overview of the current state and future directions in navigating the complexities of brain metastases management. <\/jats:p>","DOI":"10.1200\/edbk_433694","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T20:04:11Z","timestamp":1716494651000},"source":"Crossref","is-referenced-by-count":13,"title":["Navigating the Complexities of Brain Metastases Management"],"prefix":"10.1200","volume":"44","author":[{"given":"Afsaneh","family":"Amouzegar","sequence":"first","affiliation":[{"name":"Department of Melanoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Haig","sequence":"additional","affiliation":[{"name":"Lake Erie College of Osteopathic Medicine, Greensburg, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana M.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Section of Medical Oncology, Department of Medicine, Yale School of Medicine, New Haven, CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hussein A.","family":"Tawbi","sequence":"additional","affiliation":[{"name":"Department of Melanoma Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Radiation Oncology and Division of Palliative Medicine, Rochester Regional Health System, Rochester, 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