Systemic Therapy of Central Nervous System Metastases of Breast Cancer

Area of Science:

• Oncology
• Neurology
• Pharmacology

Background:

• Systemic treatment options for breast cancer brain metastases have historically been limited.
• Advances in understanding tumor biology have opened new avenues for therapy.

Purpose of the Study:

• To review important considerations for systemic therapy in breast cancer brain metastases.
• To highlight ongoing clinical trials evaluating novel agents for this condition.

Main Methods:

• Literature review of current systemic therapies.
• Analysis of emerging evidence from clinical trials.

Main Results:

• Hormone receptor-positive brain metastases may be treated with endocrine therapy or chemotherapy; CDK4/6 inhibitors are under investigation.
• HER2-positive disease has multiple treatment options, including TDM1, lapatinib-capecitabine, and emerging neratinib- and tucatinib-based combinations.
• Triple-negative tumors may respond to chemotherapy, with ongoing research for novel agents.

Conclusions:

• Effective systemic treatment options are emerging, especially for HER2-positive breast cancer brain metastases.
• Ongoing clinical trials are crucial for defining the role of novel agents and improving patient outcomes.