Challenges in Treating Brain Metastasis in HER2-Positive Breast Cancer

Sarah Sammons, MD, medical oncologist, clinical investigator in the Breast Oncology Center, associate director of the Metastatic Breast Cancer Program, Dana-Farber Cancer Institute, discusses some of the problems seen with brain metastasis in HER2-positive metastatic breast cancer.

In HER2-positive metastatic breast cancer, brain metastasis is a significant challenge that requires careful attention. According to current data, approximately one-third to one-half of patients with HER2-positive disease will develop brain metastasis, with the risk increasing as patients undergo more lines of therapy. Historically, this complication has been met with limited treatment options.

In the past, Sammons explains that many therapies used had poor penetration of the blood-brain barrier, resulting in suboptimal outcomes for these patients. Consequently, those who develop brain metastases often have inferior survival rates compared with those whose disease does not spread to the brain.

Sammons adds that managing brain metastasis in this patient population remains a complex issue, and identifying the most effective treatment options is an ongoing challenge. The need for therapies that can better penetrate the brain and provide improved outcomes for patients is critical. As Sammons highlights, developing strategies to better address brain metastasis in HER2-positive metastatic breast cancer is crucial for improving survival and quality of life for these patients, making it an area of active clinical focus.

Transcription:

0:09 | First, I would like to highlight the problem of brain metastasis in HER2-positive metastatic breast cancer. Breast cancer spreading to the brain for this particular subtype is a real problem. Depending on the trial, about one-third to one-half of patients with metastatic or HER-positive disease will develop brain metastasis, and the risk seems to go up per line of therapy.

0:41 | Brain metastasis has been historically difficult to treat. Prior therapies did not penetrate the brain very well. Patients that develop brain metastasis had inferior survival compared with those patients who did not develop brain metastasis, and so trying to figure out the best ways and to use the best medications to treat these patients has been an overall challenge.