Triplet Therapy for HER2+ Metastatic Breast Cancer and Brain Metastases

As patients with metastatic HER2+ breast cancer live longer, thanks to improvements in systemic treatment, they have up to a 50% risk for developing brain metastases at some point in the course of their illness.

To date, therapy for patients with HER2+ brain metastases has not been much different from that for other patients with brain metastases. Stereotactic radiotherapy is considered (if isolated with control of other systemic sites), as is surgical excision in certain circumstances. For patients with multiple brain metastases, for whom stereotactic radiation therapy is not indicated, whole brain radiation therapy is often recommended.

Systemic therapy for brain metastases in general has not been particularly effective. Anecdotal reports o…