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Review
. 2023 May 25;15(11):2908.
doi: 10.3390/cancers15112908.

Modern Management and Diagnostics in HER2+ Breast Cancer with CNS Metastasis

Surbhi Warrior  1 , Adam Cohen-Nowak  2 , Priya Kumthekar  3
Affiliations
Review

Modern Management and Diagnostics in HER2+ Breast Cancer with CNS Metastasis

Surbhi Warrior et al. Cancers (Basel). .

Abstract

Patients with HER2-positive breast cancer have seen improved survival and outcomes over the past two decades. As patients live longer, the incidence of CNS metastases has increased in this population. The authors' review outlines the most current data in HER2-positive brain and leptomeningeal metastases and discuss the current treatment paradigm in this disease. Up to 55% of HER2-positive breast cancer patients go on to experience CNS metastases. They may present with a variety of focal neurologic symptoms, such as speech changes or weakness, and may also have more diffuse symptoms related to high intracranial pressure, such as headaches, nausea, or vomiting. Treatment can include focal treatments, such as surgical resection or radiation (focal or whole-brain radiation), as well as systemic therapy options or even intrathecal therapy in the case of leptomeningeal disease. There have been multiple advancements in systemic therapy for these patients over the past few years, including the availability of tucatinib and trastuzumab-deruxtecan. Hope remains high as clinical trials for CNS metastases receive greater attention and as other HER2-directed methods are being studied in clinical trials with the goal of better outcomes for these patients.

Keywords: HER2-positive; brain metastasis; breast cancer.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The HER2 signaling pathway.
See this image and copyright information in PMC

References

    1. Lin N.U., Bellon J.R., Winer E.P. CNS Metastases in Breast Cancer. J. Clin. Oncol. 2004;22:3608–3617. doi: 10.1200/JCO.2004.01.175. - DOI - PubMed
    1. Barnholtz-Sloan J.S., Sloan A.E., Davis F.G., Vigneau F.D., Lai P., Sawaya R.E. Incidence Proportions of Brain Metastases in Patients Diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J. Clin. Oncol. 2004;22:2865–2872. doi: 10.1200/JCO.2004.12.149. - DOI - PubMed
    1. Zimmer A.S., Van Swearingen A.E.D., Anders C.K. HER2-positive breast cancer brain metastasis: A new and exciting landscape. Cancer Rep. 2022;5:e1274. doi: 10.1002/cnr2.1274. - DOI - PMC - PubMed
    1. Sperduto P.W., Mesko S., Li J., Cagney D., Aizer A., Lin N.U., Nesbit E., Kruser T.J., Chan J., Braunstein S., et al. Beyond an Updated Graded Prognostic Assessment (Breast GPA): A Prognostic Index and Trends in Treatment and Survival in Breast Cancer Brain Metastases from 1985 to Today. Int. J. Radiat. Oncol. Biol. Phys. 2020;107:334–343. doi: 10.1016/j.ijrobp.2020.01.051. - DOI - PMC - PubMed
    1. Arvold N.D., Oh K.S., Niemierko A., Taghian A.G., Lin N.U., Abi-Raad R.F., Sreedhara M., Harris J.R., Alexander B.M. Brain metastases after breast-conserving therapy and systemic therapy: Incidence and characteristics by biologic subtype. Breast Cancer Res. Treat. 2012;136:153–160. doi: 10.1007/s10549-012-2243-x. - DOI - PubMed