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What is the latest news on recent treatments and clinical trials for women with breast cancer brain metastasis? How can I keep up with this news?
I am a volunteer patient advocate working with women with MTNBC. There does not seem to be too much out there for these women, unfortunately and wondered if you have any thoughts or ways I can keep up with some of the new trials? thanks Steve
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MineshMehtaMD (Physician - Oncology - Radiation (Verified) ) - 07 / 03 / 2012
This is an active area for clinical research. There are a number of developments in the breast cancer field that have an impact on this. First, we have now clearly recognized that women with her2+ breast cancer are at higher risk for developing brain metastases and usually this happens later in the course of the disease. We also know that women with breast cancer with brain metastases are a heterogenous group, with quite different survival outcomes, based on a number of variables. For those with a single resectable or symptomatic lesion, surgery remains a good treatment; there is interest in investigating tumor bed radiosurgery after resection for these patients; for those with a limited number of lesions, radiosurgery with or without whole brain radiotherapy is a good approach, although there is an increasing trend toward radiosurgery alone followed by salvage as necessary, and this aspect remains under active investigation. A number of clinical trials are in development, attempting to combine focal radiosurgery plus potentially active drugs that might cross the blood-brain barrier and reduce the emergence of new metastases. This area remains investigational. In patients with multiple lesions, approaches for combining whole brain radiotherapy with agents that might enhance the efficacy of radiotherapy are being studied; examples include agents such as veliparib, lapatinib, and others. Cognitive effects after whole brain radiotherapy remain an important consideration and both physical methods and drug approaches to modify these are being evaluated, and include techniquessuch as hippocampal avoidance whole brain radiotherapy, and the investigational use of agents such as memantine and ACE inhibitors. Agents that could possibly have a direct effect on brain metastases are also in clinical trials, mostly for patientswhose disease has progressed after prior therapies.
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