Systemic Therapy Approaches for Breast Cancer Brain and Leptomeningeal Metastases

Opinion statement Brain metastasis arising from breast cancer is associated with a poor prognosis. Various systemic chemotherapy and targeted therapies which are effective against breast cancer often fail to provide benefits against brain metastasis. This is mainly due to limited penetration of the therapies across the blood-brain barrier, and divergent evolution of brain metastasis compared to the primary tumor. Thus, brain metastasis is typically treated upfront with local therapies, such as surgery and radiation, followed by systemic therapies. Systemic therapies with CNS permeability are favored in patients with brain metastasis. This paper reviews various systemic therapy options for breast cancer brain metastasis.

Automated summary

Brain metastasis from breast cancer has a poor prognosis. Systemic chemotherapy and targeted therapies often do not work against brain metastasis. Local therapies are typically used upfront, followed by systemic therapies.