Central nervous system and leptomeningeal metastases in patients with HER2-positive breast cancer: A comprehensive review and therapeutic algorithm proposal - PubMed
4 hours ago
- #HER2-positive breast cancer
- #Leptomeningeal disease
- #Brain metastases
- Breast cancer is the second leading cause of brain metastases (BMs), with increased incidence due to better imaging and longer patient survival.
- HER2-positive advanced breast cancer has a particularly high incidence of BMs and poor prognosis, with the central nervous system acting as a sanctuary site due to the blood-brain barrier.
- Traditional treatments like surgery and radiotherapy were mainstays, but new anti-HER2 agents with proven CNS efficacy have improved disease control, prompting a need for updated management strategies.
- This review covers therapeutic management of HER2-positive BMs and leptomeningeal disease, discussing recent advances in both locoregional and systemic treatments, along with screening and biomarkers for risk stratification.
- The authors propose an updated, integrated treatment algorithm to optimize clinical decision-making for HER2-positive breast cancer patients with CNS or leptomeningeal metastases.