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Systemic Treatment for Brain Metastasis and Leptomeningeal Disease in Breast Cancer Patients

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SPRINGER
DOI: 10.1007/s11912-023-01468-4

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Breast cancer; Brain metastases; Leptomeningeal disease; Systemic treatment; HER2+breast cancer; Triple negative breast cancer

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Breast cancer with brain metastasis and leptomeningeal disease is a complex and diverse disease. Despite the grim prognosis, patients with brain metastasis from breast cancer are now living longer with the availability of more systemic treatment options. Many ongoing clinical trials hold promise for further improving treatment outcomes.
Purpose of ReviewBreast cancer with brain metastasis (BCBM) and leptomeningeal disease (LMD) are important clinical problems. Traditionally, patients with metastases to the brain and meninges were excluded from clinical trials; hence, robust, evidence-based treatment recommendations are lacking. In this review, we outline the systemic treatment options and ongoing clinical trials.Recent FindingsSeveral recent studies have added to the systemic treatment options available. Antibody-drug conjugates have changed the therapeutic landscape. Combination treatment modalities that target multiple mechanisms including disruption of the blood brain barrier are increasingly being studied.SummaryBreast cancer with brain metastases and LMD is a heterogenous disease. While the prognosis remains grim, with more systemic treatment options, patients with BCBM are now living longer. Many ongoing clinical trials hold promise to further improve outcomes.

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