Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy

Abstract

Brain metastases are detected in 5% of patients with breast cancer at diagnosis. The rate of brain metastases is higher in HER2-positive and triple-negative breast cancer patients (TNBC). In patients with metastatic breast cancer, the risk of brain metastases is much higher, with up to 50% of the patients having two aggressive biological breast cancer subtypes. The prognosis for such patients is poor. Until recently, little was known about the response to systemic therapy in brain metastases. The number of trials dedicated to breast cancer with brain metastases was scarce. Our review summarizes the current knowledge on this topic including very significant results of clinical trials which have been presented very recently. We focus on the intracranial response rate of modern drugs, including new antibody–drug conjugates, HER2- targeted tyrosine kinase inhibitors and other targeted therapies. We highlight the most effective and promising drugs. On the other hand, we also suggest that further efforts are needed to improve the prognosis, especially patients with TNBC and brain metastases. The information contained in this article can help oncologists make treatment-related decisions.

Trastuzumab deruxtecan in human epidermal growth factor receptor 2-positive breast cancer brain metastases: a systematic review and meta-analysis

“…The PATRICIA phase II trial evaluated the combination of high-dose trastuzumab and pertuzumab in patients with CNS metastases who had progressed on prior radiotherapy. 27 , 28 , 29 The study reported a limited IC-ORR of 11% and a CBR of 51% at 6 months. 28 , 29 Another study, KAMILA, investigated the first ADC in metastatic BC, ado-trastuzumab emtansine (T-DM1).…”