Circulating Exosomal Integrin β3 Is Associated with Intracranial Failure and Survival in Lung Cancer Patients Receiving Cranial Irradiation for Brain Metastases: A Prospective Observational Study

摘要

Brain metastases (BM) are the most common brain tumors in adults, and it remains a major complication in cancer patients. Exosomes or extracellular vesicles (EV) and integrins contribute to the development of BM, and exosomal integrins have been shown to determine organotropic metastasis. To our knowledge, this is the first clinical evidence demonstrating that high plasma EV integrin β3 level is associated with worse overall survival and intracranial control in BM patients undergoing whole brain radiotherapy, and supports the determination of organotropic metastases by exosomal integrins in the clinical setting. As utilization of whole brain radiotherapy for BM gradually declines in favor of local therapy such as neurosurgery and stereotactic radiosurgery (SRS), intracranial and distant brain control remain relevant because of the improved survival. Circulating EV integrin β3 may serve as a novel biomarker in predicting the progression of BM and survival.