中枢神经系统（CNS）转移的患病率不断增加且预后不良，对肿瘤学提出了重大挑战，需要改进治疗策略。最近的研究揭示了脑转移瘤复杂的基因组景观，识别出独特且潜在可操作的基因改变。这些见解为靶向治疗提供了新途径，凸显了精准医学方法在治疗中枢神经系统转移方面的潜力。然而，将这些发现转化为临床实践需要克服挑战，例如用于表征的组织的可用性、分子测试的可及性、跨血脑屏障（BBB）的药物输送以及解决肿瘤内和肿瘤间遗传异质性。这篇综述探讨了对中枢神经系统转移的演变、其发展的分子机制以及对治疗干预的影响的新见解。版权所有 © 2024 Elsevier Ltd. 保留所有权利。

The increasing prevalence and poor prognosis of central nervous system (CNS) metastases pose a significant challenge in oncology, necessitating improved therapeutic strategies. Recent research has shed light on the complex genomic landscape of brain metastases, identifying unique and potentially actionable genetic alterations. These insights offer new avenues for targeted therapy, highlighting the potential of precision medicine approaches in treating CNS metastases. However, translating these discoveries into clinical practice requires overcoming challenges such as availability of tissue for characterization, access to molecular testing, drug delivery across the blood-brain barrier (BBB) and addressing intra- and intertumoral genetic heterogeneity. This review explores novel insights into the evolution of CNS metastases, the molecular mechanisms underlying their development, and implications for therapeutic interventions.Copyright © 2024 Elsevier Ltd. All rights reserved.