Breast Cancer Brain Metastasis-Overview of Disease State, Treatment Options and Future Perspectives

Abstract

Breast cancer is the second most common origin of brain metastasis after lung cancer. Brain metastasis in breast cancer is commonly found in patients with advanced course disease and has a poor prognosis because the blood-brain barrier is thought to be a major obstacle to the delivery of many drugs in the central nervous system. Therefore, local treatments including surgery, stereotactic radiation therapy, and whole-brain radiation therapy are currently considered the gold standard treatments. Meanwhile, new targeted therapies based on subtype have recently been developed. Some drugs can exceed the blood-brain barrier and enter the central nervous system. New technology for early detection and personalized medicine for metastasis are warranted. In this review, we summarize the historical overview of treatment with a focus on local treatment, the latest drug treatment strategies, and future perspectives using novel therapeutic agents for breast cancer patients with brain metastasis, including ongoing clinical trials.

Keywords: BRCA gene mutation; CDK4/6 inhibitor; blood–brain barrier; central nervous system; immune checkpoint inhibitor; molecular-targeted therapy; neurosurgery; review; stereotactic radiosurgery (SRS); tyrosine kinase inhibitor; whole brain radiation therapy (WBRT).