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Systemic Therapy of Brain Metastases: Breast Cancer

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Central Nervous System Metastases

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Abstract

The management of breast cancer brain metastases (BCBM) represents an ongoing challenge in the treatment of breast cancer. To date, surgical resection and/or radiation therapy is the primary management option for BCBM, depending on patient factors, tumor subtype, tumor quantity, and location of lesions. Traditionally, systemic therapy has not been employed in the first-line management of BCBM; rather, it has been reserved as salvage therapy following local therapy or to jointly control extra-axial disease. Ongoing research suggests that systemic therapy may have a broader role in the first-line setting, as secondary prevention and as treatment of side effects from local therapy. With the improved understanding of the blood-brain barrier (BBB)/brain-tumor barrier (BTB), ongoing research has uncovered novel targets and drugs for the treatment of BCBM, including CDK 4/6 inhibitors, human epidermal growth factor receptor 2 (HER2)-directed therapy, cytotoxic therapy, tyrosine kinase inhibitor (TKIs), poly-ADP ribose polymerase (PARP) inhibitors, estrogen modulator therapy, and novel formulations of existing agents. Ultimately, further research and inclusion of patients with BCBM in clinical trials are needed in order to more effectively treat patients with BCBM and improve both quality of life and overall prognosis.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    Leigh Klaus Swartz & Aki Morikawa

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  1. Leigh Klaus Swartz
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  2. Aki Morikawa
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Correspondence to Aki Morikawa .

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Editors and Affiliations

  1. Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, Director - Brain Metastases Program, New York, NY, USA

    Rohan Ramakrishna

  2. Department of Neurology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA

    Rajiv S. Magge

  3. Department of Neurological Surgery, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA

    Ali A. Baaj

  4. Department of Radiation Oncology, NewYork-Presbyterian Hospital/Weill Cornell Medicine, New York, NY, USA

    Jonathan P.S. Knisely

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Swartz, L.K., Morikawa, A. (2020). Systemic Therapy of Brain Metastases: Breast Cancer. In: Ramakrishna, R., Magge, R., Baaj, A., Knisely, J. (eds) Central Nervous System Metastases. Springer, Cham. https://doi.org/10.1007/978-3-030-42958-4_15

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  • DOI: https://doi.org/10.1007/978-3-030-42958-4_15

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