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Journal of Neuro-Oncology

, Volume 79, Issue 3, pp 289–292 | Cite as

HER2-positive Breast Cancer Brain Metastases: Multiple Responses to Systemic Chemotherapy and Trastuzumab—a Case Report

  • D. N. Church
  • A. Bahl
  • A. Jones
  • C. G. A. PriceEmail author
Clinical-Patient Studies

Abstract

Brain metastases from metastatic breast cancer typically occur in 10–15% of patients and are associated with survival of 3–6 months. Recent series have shown that women with HER2-postive metastatic breast cancer receiving the drug trastuzumab develop brain metastases more frequently than this, but also that continuation of trastuzumab after diagnosis of brain metastases in such patients is associated with extended survival. Authors have speculated that this is due to improved systemic control of disease; however, a possibility is that trastuzumab may have a beneficial effect on cerebral metastases themselves. We report the case of a woman with HER2-positive metastatic breast cancer who developed multiple brain metastases while on trastuzumab, in whom the addition of systemic chemotherapy to continued trastuzumab has produced multiple treatment responses associated with prolonged survival. This is the first report of its kind.

Keywords

Brain metastases Breast cancer C-erbB2 HER2 Chemotherapy Trastuzumab Herceptin® 

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References

  1. 1.
    Slamon DJ, Clark GM, Wong SG, et al. (1987) Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235:177–182PubMedCrossRefGoogle Scholar
  2. 2.
    Slamon DJ, Leyland-Jones B, Shak S, et al. (2001) Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 344:783–792PubMedCrossRefGoogle Scholar
  3. 3.
    Bendell JC, Domchek SM, Burstein HJ, et al. (2003) Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma. Cancer 97:2972–2977PubMedCrossRefGoogle Scholar
  4. 4.
    Clayton AJ, Danson S, Jolly S, et al. (2004) Incidence of cerebral metastases in patients treated with trastuzumab for metastatic breast cancer. Br J Cancer 91:639–643PubMedGoogle Scholar
  5. 5.
    Kirsch DG, Ledezma CJ, Mathews CS, et al. (2005) Survival after brain metastases from breast cancer in the trastuzumab era. J Clin Oncol 23:2114–2116; author reply 2116–2117Google Scholar
  6. 6.
    Pestalozzi BC, Brignoli S (2000) Trastuzumab in CSF. J Clin Oncol 18:2349–2351PubMedGoogle Scholar
  7. 7.
    Stewart DJ, Mikhael NZ, Nair RC, et al. (1988) Platinum concentrations in human autopsy tumor samples. Am J Clin Oncol 11:152–158PubMedCrossRefGoogle Scholar
  8. 8.
    Rosner D, Nemoto T, Lane WW (1986) Chemotherapy induces regression of brain metastases in breast carcinoma. Cancer 58:832–839PubMedCrossRefGoogle Scholar
  9. 9.
    Weinstein JD, Toy FJ, Jaffe ME, Goldberg HI (1973) The effect of dexamethasone on brain edema in patients with metastatic brain tumors. Neurology 23:121–129PubMedGoogle Scholar
  10. 10.
    Pegram MD, Konecny GE, O’Callaghan C, et al. (2004) Rational combinations of trastuzumab with chemotherapeutic drugs used in the treatment of breast cancer. J Natl Cancer Inst 96:739–749PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • D. N. Church
    • 1
  • A. Bahl
    • 2
  • A. Jones
    • 3
  • C. G. A. Price
    • 1
    Email author
  1. 1.Department of Medical OncologyBristol Haematology and Oncology CentreBristolUK
  2. 2.Department of Clinical OncologyBristol Haematology and Oncology CentreBristolUK
  3. 3.Department of RadiologyBristol Royal InfirmaryBristolUK

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