Decoding HER2+ Breast Cancer: Challenges in Brain Metastases


Experts explore the intricacies of managing brain metastases in HER2+ breast cancer and delve into the latest evidence, patient considerations, and evolving guidelines for this complex scenario.

This is a video synopsis/summary of a Peer Exchange involving Joyce O’Shaughnessy, MD; Priyanka Sharma, MD; Claudine Isaacs, MD; Heather McArthur, MD; and Hope S. Rugo, MD, FASCO.

O’Shaughnessy and Rugo discuss the management of HER2-positive breast cancer with brain metastases, highlighting the impact of the HER2CLIMB trial on treatment decisions. Rugo emphasizes the survival advantage observed in patients with active brain metastases, particularly with the tucatinib regimen, as demonstrated in the trial. The discussion delves into the challenges of treating patients with asymptomatic brain metastases and the evolving role of surveillance brain MRIs. Rugo sheds light on a flatiron database analysis, showcasing the cumulative incidence of brain metastases over time in patients with HER2-positive breast cancer. The findings reveal that by the third line of therapy, almost all patients with HER2-positive disease prone to brain metastases have developed them. This early occurrence differs from other breast cancer subtypes. The discussion underscores the complexities of treating brain metastases and the need for tailored approaches based on evolving evidence.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.

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