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Christopher Alvarez-Breckenridge, Priscilla K Brastianos, Daniel P Cahill, Thrombosis, brain metastasis formation, and the perivascular metastatic niche—Novel insights from the tumor microvascular circulation, Neuro-Oncology, Volume 26, Issue 11, November 2024, Pages 2100–2101, https://doi.org/10.1093/neuonc/noae168
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Significant attention has been devoted to enhancing our understanding of brain metastases, as they remain a dreaded end-stage complication of multiple tumor histologies. Numerous studies have attempted to investigate the defining features of the metastatic brain tumor microenvironment, in search of common cooccurring immunologic, genetic, metabolic, and neuronal features, with an ultimate goal of developing therapeutic targets to prevent brain metastasis formation.1 Despite these advances, unresolved questions remain regarding the initial steps within the tumor microvasculature leading to the intracranial metastatic cascade. Studies exploring brain tumor seeding and angiogenesis have focused on the unique hemodynamic interplay between tumor cells and the microvascular network within the brain.2 While various cellular mediators have been linked to this metastatic process, Angiopoietin-2 (Ang-2) and vascular endothelial growth factor (VEGF) have been implicated as key pro-angiogenic regulators that impair the integrity of the blood-brain barrier, promote cellular transmigration into the central nervous system, and drive metastatic seeding within the perivascular niche.3–5