AUTHOR=Ramkissoon Lori A. , Pegram Worthy , Haberberger James , Danziger Natalie , Lesser Glenn , Strowd Roy , Dahiya Sonika , Cummings Thomas J. , Bi Wenya Linda , Abedalthagafi Malak , Sathyan Pratheesh , McGregor Kimberly , Reddy Prasanth , Severson Eric , Williams Erik , Lin Douglas , Edgerly Claire , Huang Richard S. P. , Hemmerich Amanda , Creeden James , Brown Charlotte , Venstrom Jeffrey , Hegde Priti , Ross Jeffrey S. , Alexander Brian M. , Elvin Julia , Ramkissoon Shakti H. TITLE=Genomic Profiling of Circulating Tumor DNA From Cerebrospinal Fluid to Guide Clinical Decision Making for Patients With Primary and Metastatic Brain Tumors JOURNAL=Frontiers in Neurology VOLUME=11 YEAR=2020 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.544680 DOI=10.3389/fneur.2020.544680 ISSN=1664-2295 ABSTRACT=

Despite advances in systemic therapies for solid tumors, the development of brain metastases remains a significant contributor to overall cancer mortality and requires improved methods for diagnosing and treating these lesions. Similarly, the prognosis for malignant primary brain tumors remains poor with little improvement in overall survival over the last several decades. In both primary and metastatic central nervous system (CNS) tumors, the challenge from a clinical perspective centers on detecting CNS dissemination early and understanding how CNS lesions differ from the primary tumor, in order to determine potential treatment strategies. Acquiring tissue from CNS tumors has historically been accomplished through invasive neurosurgical procedures, which restricts the number of patients to those who can safely undergo a surgical procedure, and for which such interventions will add meaningful value to the care of the patient. In this review we discuss the potential of analyzing cell free DNA shed from tumor cells that is contained within the cerebrospinal fluid (CSF) as a sensitive and minimally invasive method to detect and characterize primary and metastatic tumors in the CNS.