Abstract
Purpose of the Review
Historically, systemic treatment options for patients with breast cancer brain metastases have been very limited. This review focuses on important considerations for systemic therapy as well as ongoing clinical trials evaluating novel agents.
Recent Findings
For patients with hormone receptor-positive brain metastases, endocrine therapy or chemotherapy options can be considered. The role of CDK4/6 inhibitors is being explored in ongoing trials. Patients with HER2-positive disease have a number of treatment options, including ado-trastuzumab emtansine (TDM1) or lapatinib-capecitabine, and there is emerging evidence of the efficacy of neratinib- and tucatinib-based chemotherapy combinations in the CNS. Triple-negative tumors may respond to chemotherapy.
Summary
Although much progress remains to be made, a number of effective systemic treatment options are emerging, particularly for patients with HER2-positive disease. Ongoing clinical trials will help define the role of novel agents.
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Change history
17 May 2019
The original version of this article, which published in Current Oncology Reports, Volume 21, Issue 6, June 2019, contained an error in addressing the indication for use of neratinib in early stage breast cancer.
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José Pablo Leone has received research funds paid to his institution (University of Iowa) from Merck and has also received research funds from Kazia Therapeutics and Eli Lilly.
Nancy U. Lin has received funding for clinical trials from Genentech, Seattle Genetics, Novartis, and Pfizer, and has received compensation from Puma and Daiichi for service as a consultant.
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Leone, J.P., Lin, N.U. Systemic Therapy of Central Nervous System Metastases of Breast Cancer. Curr Oncol Rep 21, 49 (2019). https://doi.org/10.1007/s11912-019-0802-6
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DOI: https://doi.org/10.1007/s11912-019-0802-6