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The present microarray analysis showed that PTEN is significantly downregulated in brain metastases compared with nonmetastatic primary tumors.
Interestingly, CD68+ TAMs had significantly more frequently a dense CCR2-positive infiltrate in brain metastases compared with primary RCC (13.9% vs 43.7% P<0.001).
The herewith presented study identified strong endothelial CCR2 expression in brain metastases but also stronger CCR2 expression in tumour cells of brain metastases compared with primary RCC.
Furthermore, PTEN mRNA expression was significantly downregulated in brain metastases compared with primary tumors, and PTEN mutations were frequently found in brain metastases.
Furthermore, we have found a more frequent CCR2 overexpression in tumour cells of brain metastases compared with primary tumour cells (P<0.0001).
Animals that received fluoxetine demonstrated a 52% increase in the total number of brain metastases compared with control: fluoxetine (n = 11), 35.54 ± 3.90 vs. control (n = 12), 23.33 ± 2.46 tumors/section, p = 0.02.
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Of those, 7 of 15 (46.6%) with a negative ER status developed brain metastases compared to 5 of 34 (14.7%) with a positive ER status (Fisher exact test, p = 0.03).
Past studies of MBM patients have also shown worse survival outcomes in patients with a large number of brain metastases, compared to only 1 3 brain metastases 6, 26, 27.
Higher brain penetration in metastases compared with normal brain was also hypothesised due to the disruption of the BBB in cranial metastases.
However, tissue exposure was significantly higher in metastases compared with normal brain (p = 0.002 (Figure 3C,D and Table 4)).
Mean TAC for normal brain from the day 8 scans plotted with individual TACs for brain metastases (Figure 3A) and with mean whole blood and plasma [11C]lapatinib TAC (Figure 3B) illustrates the high variability of uptake in metastases compared with normal brain.
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