Neuro–astrocytic network in breast cancer brain metastases: Adaptive mechanisms and novel therapeutic targets

Breast cancer brain metastases (BrM) are a common and fatal complication in advanced breast cancer patients, with the intricate brain microenvironment significantly limiting the efficacy of current therapeutic strategies. Recently, the neuro-astrocytic network, as a core component of the brain metastasis microenvironment, has garnered extensive attention for its pivotal role in supporting tumor adaptive growth. This review systematically outlines the adaptive mechanisms of the neuro-astrocytic network in BrM, including bidirectional interactions between tumor cells, neurons, and astrocytes, and their profound effects on synapse-like signaling, metabolic pathways, and regulatory networks. Furthermore, we integrate recent advancements in exploring therapeutic targets and discuss potential intervention strategies against tumor-microenvironment interactions and associated challenges. Future research focusing on the multi-target collaborative mechanisms within this network and its clinical translational potential may provide new avenues for precise treatment of BrM.