Review
Oncology
Matthew N. Mills, Whitney King, Aixa Soyano, Yolanda Pina, Brian J. Czerniecki, Peter A. Forsyth, Hatem Soliman, Hyo S. Han, Kamran A. Ahmed
Summary: Patients with HER2-positive breast cancer are at a high risk of breast cancer brain metastasis and leptomeningeal disease. The management of these cases is rapidly evolving and requires a multidisciplinary approach. Advances in systemic therapy have improved survival, and ongoing clinical trials are investigating potential targeted therapies.
JOURNAL OF NEURO-ONCOLOGY
(2022)
Review
Oncology
E. Stavrou, E. P. Winer, N. U. Lin
Summary: The overexpression of the HER2/neu receptor in breast cancer is associated with an increased risk of brain metastases, especially in advanced cases. Management of HER2-positive brain metastases often involves surgery, radiation, and systemic therapies by an experienced multidisciplinary team, and poses unique clinical challenges in prevention and treatment.
Article
Oncology
Naoki Niikura, Takashi Yamanaka, Hironori Nomura, Kazuhiro Shiraishi, Hiroki Kusama, Mitsugu Yamamoto, Kazuo Matsuura, Kenichi Inoue, Sachiko Takahara, Shosuke Kita, Miki Yamaguchi, Tomoyuki Aruga, Nobuhiro Shibata, Akihiko Shimomura, Yuri Ozaki, Shuji Sakai, Yoko Kiga, Tadahiro Izutani, Kazuhito Shiosakai, Junji Tsurutani
Summary: This study reports on the effectiveness and safety of trastuzumab deruxtecan in breast cancer patients with brain metastases and leptomeningeal carcinomatosis. The results show that trastuzumab deruxtecan provides disease control in both the brain and systemic levels, with a satisfactory overall response rate and progression-free survival.
Article
Oncology
Nayan Lamba, Patrick Y. Wen, Ayal A. Aizer
Summary: Brain metastases significantly impact patients with advanced extracranial malignancies, but their incidence remains poorly described. Recent studies have shown the viability of using claims data for epidemiologic investigations of brain metastases.
Article
Oncology
Camille Faure, Rym Djerbi-Bouillie, Anais Domingot, Haniaa Bouzinba-Segard, Said Taouji, Yanis Saidi, Sandra Bernard, Floriane Carallis, Romy Rothe-Walther, Jean-Luc Lenormand, Eric Chevet, Sandrine Bourdoulous
Summary: Therapies targeting the tyrosine kinase receptor HER2 have significantly improved survival of patients with HER2(+) cancer. However, resistance remains a challenge, particularly in the brain metastatic setting. This study identifies a novel class of allosteric HER2 inhibitors, including a compound mimicking Moesin, which effectively inhibits HER2(+) breast tumor progression and shows significant activity on HER2(+) brain tumor progression.
Article
Oncology
Alessia Pellerino, Riccardo Soffietti, Francesco Bruno, Roberta Manna, Erminia Muscolino, Pierangela Botta, Rosa Palmiero, Roberta Ruda
Summary: The study evaluated the efficacy and tolerability of neratinib in association with capecitabine in patients with leptomeningeal metastases from heavily pretreated HER2-positive breast cancer. Results showed clinical efficacy in some patients, suggesting further investigation in larger studies.
Article
Oncology
Laura Alder, Dario Trapani, Claire Bradbury, Amanda E. D. Van Swearingen, Sara M. Tolaney, Mustafa Khasraw, Carey K. Anders, Christopher D. Lascola, Liangge Hsu, Nancy U. Lin, Sarah Sammons
Summary: In a case series of 8 heavily pretreated HER2+ metastatic breast cancer patients with leptomeningeal metastases (LM), all 8 patients (100%) derived clinical benefit from Trastuzumab deruxtecan (TDXd), and 4 patients (50%) had an objective partial response based on formal neuroradiology MRI reads using the EORTC/RANO-LM Revised-Scorecard. T-DXd should be further studied in LM in HER2+ MBC and solid tumors where T-DXd may be active.
Review
Clinical Neurology
Jessica A. Wilcox, Min Jun Li, Adrienne A. Boire
Summary: Leptomeningeal metastases, which can cause significant neurological damage and death, remains a challenging disease to treat. However, there is hope as several studies and clinical trials have shown that certain cancer-directed strategies are effective in improving survival rates for patients with this condition. Further clinical trials are needed to establish the efficacy of treatments and to explore new avenues of treatment.
Article
Oncology
Anna-Maria Lazaratos, Sarah M. Maritan, Andrea Quaiattini, Amelie Darlix, Ivica Ratosa, Emanuela Ferraro, Gaia Griguolo, Valentina Guarneri, Alessia Pellerino, Silvia Hofer, William Jacot, Hans-Joachim Stemmler, Marcel P. H. van den Broek, Nika Dobnikar, Francois Panet, Zubin Lahijanian, Aki Morikawa, Andrew D. Seidman, Riccardo Soffietti, Lawrence Panasci, Kevin Petrecca, April A. N. Rose, Nathaniel Bouganim, Matthew Dankner
Summary: Intrathecal administration of HER2-targeted therapy does not provide additional benefits for HER2+ breast cancer patients with leptomeningeal metastases compared to oral or intravenous treatment regimens. However, treatment with trastuzumab-deruxtecan may lead to prolonged overall survival for these patients, but further research is needed to confirm this.
Article
Cell Biology
Ying Meng, Raymond M. Reilly, Rossanna C. Pezo, Maureen Trudeau, Arjun Sahgal, Amit Singnurkar, James Perry, Sten Myrehaug, Christopher B. Pople, Benjamin Davidson, Maheleth Llinas, Chinthaka Hyen, Yuexi Huang, Clement Hamani, Suganth Suppiah, Kullervo Hynynen, Nir Lipsman
Summary: This study provides evidence of enhanced brain penetration of trastuzumab using MRgFUS in patients with Her2-positive breast cancer, demonstrating the potential of this technology for a broad range of CNS diseases.
SCIENCE TRANSLATIONAL MEDICINE
(2021)
Review
Oncology
Akanksha Sharma, Lauren Singer, Priya Kumthekar
Summary: Metastatic disease to the central nervous system is a serious complication with high mortality rates. Advances in targeted therapy and immunotherapy have led to successful penetration and efficacy within the CNS, improving treatment options for patients. Identifying key targets in tumorigenesis pathway and upcoming trials continue to promise significant progress in managing CNS metastases.
Review
Oncology
Alejandro Garcia-Alvarez, Andri Papakonstantinou, Mafalda Oliveira
Summary: Development of brain metastases is a significant event for patients with breast cancer, particularly those with HER2-positive tumors. Advances in targeted therapy against the HER2 receptor have improved management of HER2-positive breast cancer. Despite these improvements, brain metastases continue to be a challenge, highlighting the need for further research and innovative treatment strategies.
Article
Medicine, General & Internal
Xiaoping Ma, Yan Li, Li Li, Chunyan Gao, Dan Liu, Hongyu Li, Zhenhui Zhao, Bing Zhao
Summary: The study explored effective methods through combining pyrotinib to treat brain metastasis with HER2-positive advanced breast cancer. Pyrotinib-based combination therapy was found to be safe and efficient for treating HER2-positive brain metastasis, with pyrotinib combined with nab-paclitaxel showing superior efficacy.
ANNALS OF MEDICINE
(2022)
Review
Oncology
Daniele Galanti, Alessandro Inno, Maria La Vecchia, Nicolo Borsellino, Lorena Incorvaia, Antonio Russo, Stefania Gori
Summary: Brain metastases are often associated with HER2+ breast cancer, and systemic therapy with trastuzumab has been the mainstay. Other HER2-targeted agents have been introduced in clinical practice, with newer agents such as neratinib, tucatinib, and trastuzumab deruxtecan showing interesting activity against brain metastases. Further research is needed to elucidate the optimal sequence of these agents and their combination with local treatment.
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
(2021)
Article
Clinical Neurology
Ishaan Ashwini Tewarie, Alexander W. Senko, Charissa A. C. Jessurun, Abigail Tianai Zhang, Alexander F. C. Hulsbergen, Luis Rendon, Jack McNulty, Marike L. D. Broekman, Luke C. Peng, Timothy R. Smith, John G. Phillips
Summary: The incidence of leptomeningeal disease (LMD) has increased due to improved treatments for brain metastases (BMs) and longer survival of patients with metastatic disease. This study used machine learning techniques to enhance LMD prediction after surgery for BMs, and found that lymph node metastasis and cerebellar BM location were the strongest risk factors for LMD occurrence and time to LMD.
JOURNAL OF NEUROSURGERY
(2023)