Strategies for Preventing Breast Cancer Brain Metastases

In patients with metastatic breast cancer, the development of brain metastases is a devastating event, as it often portends a rapid decline in survival. Treatment has focused largely on surgery, when possible, or on various types of radiation therapy. An obstacle to the development of systemic treatments is the inability of drugs such as trastuzumab — which is effective for human epidermal growth factor receptor 2 (HER2)-positive breast cancer — to penetrate the blood-brain barrier. Two drugs that have been reported to both treat established brain metastases and, anecdotally, to prevent brain metastases are capecitabine and lapatinib.

Now, investigators have conducted an industry-supported, phase III, randomized, multicenter, open-label stud…