Society for Neuro-Oncology 2014 annual meeting updates on central nervous system metastases.

INTRODUCTION The 19th Annual Meeting of the Society for Neuro-Oncology (SNO) took place in November of 2014. The focus of many abstracts, as well as the Education Day, was on recent advances in the study of central nervous system (CNS) metastases. TUMOR BIOLOGY Key studies evaluating the factors in tumors and their microenvironment associated with the development and growth of brain metastases are reviewed. PROGNOSTICATION Studies investigating the factors that independently influence survival in participants with brain metastases are presented. RESPONSE ASSESSMENT The Response Assessment for Neuro-Oncology criteria for brain metastases (RANO-BM) and the Neurological Assessment in Neuro-Oncology (NANO) criteria, which were both presented, are recapped. RADIOTHERAPY Studies are reviewed evaluating factors that influence survival outcomes in participants with brain metastases who were treated with radiotherapy. Studies investigating the potential risk of radiation necrosis with the combination of radiotherapy and immunotherapies are presented. SYSTEMIC THERAPIES Brain metastases-focused subset analyses from the ASCEND-1 trial for ALK-translocated non-small cell lung cancer are presented. Preclinical and clinical work on solid tumor leptomeningeal carcinomatosis is also covered. SEQUELAE OF CENTRAL NERVOUS SYSTEM METASTASES AND THEIR TREATMENTS An overview is provided of treatment- related toxicities as well as important concepts that may influence strategies to protect against these toxicities. CONCLUSIONS Key concepts regarding tumor biology, prognostication, response assessment, therapeutic management, and sequelae of treatment for CNS metastases are summarized. Advances in our understanding of the basic and clinical science of CNS metastases have the potential to improve outcomes for patients.