Brain Metastasis from Renal Carcinoma: Locoregional and Systemic Treatments

Abstract Brain metastases occur in 20–40% of cancers. Intracranial bleeding is one of the fatal complications encountered in this context. Primitive tumor is mainly located in lung (40%), breast (17%), melanoma (10%), and kidney or bladder (6%). Increased incidence could be explained by (1) treatment’s resistance by clonal escape, (2) improvements in diagnostic technologies, and (3) overall survival in cancer patients as a result of medicine improvement. Treatments of brain metastases include local (surgery, radiotherapy) and systemic (chemotherapies, targeted therapies) treatments. Better understanding of the role of angiogenesis and the key angiogenic factors in cancers and brain metastases development lead to setting up of a new therapeutic approach against brain metastasis by angiogenesis targeting. Available data on efficacy and safety of antiangiogenic drugs (monoclonal antibodies, tyrosine kinase inhibitors, and mammalian inhibitors) suggest an efficacy on brain metastasis without extra toxicity in this subpopulation. Future challenges will be the evaluation of specific efficacy of antiangiogenic drugs on brain metastasis and investigation of new treatment strategies to optimize the benefit–risk ratio of these drugs.