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Systemic Treatment for Brain Metastasis and Leptomeningeal Disease in Breast Cancer Patients
Sushant Puri1,2, Amina Chaudhry3, Asnakech Bayable2
1Neurooncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Purpose Of Review:
Breast 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 Findings:
Several 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. Breast 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.
Insights
Systemic treatments for breast cancer with brain metastasis (BCBM) and leptomeningeal disease (LMD) are evolving. New therapies and clinical trials offer hope for improved outcomes in this challenging condition.
Area of Science:
- Oncology
- Neurology
- Translational Medicine
Background:
- Breast cancer with brain metastasis (BCBM) and leptomeningeal disease (LMD) present significant clinical challenges.
- Historically, patients with brain and meningeal metastases were excluded from clinical trials, limiting evidence-based treatment guidelines.
Purpose of the Study:
- To review current systemic treatment options for BCBM and LMD.
- To discuss ongoing clinical trials investigating novel therapeutic strategies.
Main Methods:
- Literature review of recent studies and clinical trial data.
- Analysis of emerging systemic treatment modalities for BCBM and LMD.
Main Results:
- Antibody-drug conjugates have significantly impacted the therapeutic landscape for BCBM and LMD.
- Combination therapies targeting multiple mechanisms, including blood-brain barrier disruption, are under investigation.
- Despite a historically grim prognosis, advancements are leading to longer survival for patients with BCBM.
Conclusions:
- The therapeutic landscape for BCBM and LMD is rapidly evolving with new systemic options.
- Ongoing clinical trials show promise for further improving patient outcomes.
- BCBM and LMD remain heterogeneous diseases requiring tailored treatment approaches.
