Brain metastases in her2-positive breast cancer: new opportunities for systemic therapy

Abstract


This article dials with the new opportunities for the treatment of HER2-positive breast cancer with the involvement of the central nervous system (CNS). In CEREBEL study was shown that trastuzumab was not inferior to lapatinib concerning the reduction the incidence of brain metastases and had statistically significant progression-free survival advantages. The new strategy of the 1st-line therapy in disseminated HER2-positive breast cancer is to apply dual receptor blockade using two monoclonal antibodies (trastuzumab + pertuzumab) in combination with taxanes. This approach has been highly effective, even in the patients with the involvement of the CNS: the addition of pertuzumab into the combination of trastuzumab + docetaxel has increased the median time to development of CNS metastases as first site of disease progression from 11,9 to 15 months, and median overall survival - from 26,3 to 34,4 months. On the progression of HER2-positive metastatic breast cancer after usage of trastuzumab and taxanes, the advantage of new drug - T-DM1 was proven over the combination of lapatinib and capecitabin, even in the patients with brain metastases: the advantage of median overall survival in these patients was reached 13,9 months.

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About the authors

E V Artamonova

N.N.Blochin Russian Cancer Research Center

Email: artamonovae@mail.ru
115478, Russian Federation, Moscow, Kashirskoe sh., d. 23

L V Manziuk

N.N.Blochin Russian Cancer Research Center

115478, Russian Federation, Moscow, Kashirskoe sh., d. 23

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