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Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy
SIMPLE SUMMARY: For many years, patients with breast cancer and brain metastases were excluded from participation in clinical trials. It was believed that anticancer drugs could not cross the blood–brain barrier. However, recent evidence strongly suggests that some drugs can act against brain metast...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8869862/ https://www.ncbi.nlm.nih.gov/pubmed/35205723 http://dx.doi.org/10.3390/cancers14040965 |
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author | Niwinska, Anna Pogoda, Katarzyna Jagiello-Gruszfeld, Agnieszka Duchnowska, Renata |
author_facet | Niwinska, Anna Pogoda, Katarzyna Jagiello-Gruszfeld, Agnieszka Duchnowska, Renata |
author_sort | Niwinska, Anna |
collection | PubMed |
description | SIMPLE SUMMARY: For many years, patients with breast cancer and brain metastases were excluded from participation in clinical trials. It was believed that anticancer drugs could not cross the blood–brain barrier. However, recent evidence strongly suggests that some drugs can act against brain metastases, with the greatest intracranial response rate reported in the case of capecitabine, neratinib plus capecitabine, trastuzumab deruxtecan and tucatinib plus trastuzumab and capecitabine. In this article, we discuss the achievements in systemic therapy of breast cancer patients with brain metastases. We stress on the newest clinical trial results which indicate tremendous progress in HER2-positive breast cancer. On the other hand, in patients with triple-negative breast cancer or hormone-receptor-positive brain metastases, much fewer compounds were discovered. Based on the presented results, patients with active brain metastases should be routinely included in clinical trials with novel agents. 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. |
format | Online Article Text |
id | pubmed-8869862 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88698622022-02-25 Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy Niwinska, Anna Pogoda, Katarzyna Jagiello-Gruszfeld, Agnieszka Duchnowska, Renata Cancers (Basel) Review SIMPLE SUMMARY: For many years, patients with breast cancer and brain metastases were excluded from participation in clinical trials. It was believed that anticancer drugs could not cross the blood–brain barrier. However, recent evidence strongly suggests that some drugs can act against brain metastases, with the greatest intracranial response rate reported in the case of capecitabine, neratinib plus capecitabine, trastuzumab deruxtecan and tucatinib plus trastuzumab and capecitabine. In this article, we discuss the achievements in systemic therapy of breast cancer patients with brain metastases. We stress on the newest clinical trial results which indicate tremendous progress in HER2-positive breast cancer. On the other hand, in patients with triple-negative breast cancer or hormone-receptor-positive brain metastases, much fewer compounds were discovered. Based on the presented results, patients with active brain metastases should be routinely included in clinical trials with novel agents. 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. MDPI 2022-02-15 /pmc/articles/PMC8869862/ /pubmed/35205723 http://dx.doi.org/10.3390/cancers14040965 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Niwinska, Anna Pogoda, Katarzyna Jagiello-Gruszfeld, Agnieszka Duchnowska, Renata Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy |
title | Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy |
title_full | Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy |
title_fullStr | Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy |
title_full_unstemmed | Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy |
title_short | Intracranial Response Rate in Patients with Breast Cancer Brain Metastases after Systemic Therapy |
title_sort | intracranial response rate in patients with breast cancer brain metastases after systemic therapy |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8869862/ https://www.ncbi.nlm.nih.gov/pubmed/35205723 http://dx.doi.org/10.3390/cancers14040965 |
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