Dr. Piccioni on Tumor Profiles of Brain Metastases

David Piccioni, MD, PhD, assistant professor, Neuroscience and Neuro-Oncology, UC San Diego Health, discusses tumor profiling of brain metastases of patients with non-small cell lung cancer, breast cancer, and melanoma.

Molecular profiling was done in a multi-model approach using sequencing, immunohistochemistry, and in situ hybridization, to examine the parameters between primary tumors and brain metastases. As more primary cancers are cured and patients are surviving longer, Piccioni adds, there is a higher risk of developing brain metastases. This study sought to determine if the molecular profile in tumors change over time and if any differences exist between brain metastases and a patient’s original tumor.

Primary tumors were examined in non—small cell lung cancer, breast cancer, and melanoma. Expression of TOPO1 and TOP2A were found to be higher in brain metastases. Agents are available to target these expressions, as well as the blood-brain barrier, Piccioni adds. Also, EGFR mutations and HER2 expression were found to be higher in brain metastases from breast cancer, which can be treated with lapatinib.