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Vol 6, No 5 (2010)
Review paper
Published online: 2011-01-19
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Central nervous system metastases during anti-HER2 therapy in breast cancer patients

Renata Duchnowska
Onkol. Prak. Klin 2010;6(5):272-277.

open access

Vol 6, No 5 (2010)
REVIEW ARTICLES
Published online: 2011-01-19

Abstract

Breast cancer is among malignancies with high risk of brain relapse. Particularly high risk of brain relapse demonstrate breast cancer patients with overexpression or amplification of HER2 gene. This phenomenon is probably related to genetic characteristics of both the tumor and the patient, and a type of treatment. Currently, a standard component of systemic therapy of HER2-positive breast cancer is trastuzumab, a monoclonal antibody against extracellular domain of HER2 receptor. Control of extracranial disease with trastuzumab increases the risk of brain metastases, which frequently occur during systemic stabilization or regression of other lesions. However, due to its high molecular weight and physico-chemical properties, trastuzumab does not cross through the blood-brain barrier and is ineffective in preventing and treating brain lesions. Another anti-HER agent used in breast cancer is lapatinib, a small-molecule tyrosine kinase inhibitor. Lapatinib has slightly higher ability to cross the blood-brain barrier, however activity in established brain metastases is modest. Experimental and clinical observations suggest, however, the role of lapatinib in prevention of brain metastases. In summary, the current progress in therapy of brain metastasis in HER2-positive breast cancer patients is fairly small and this problem remains a therapeutic challenge.

Onkol. Prak. Klin. 2010; 6, 5: 272–277

Abstract

Breast cancer is among malignancies with high risk of brain relapse. Particularly high risk of brain relapse demonstrate breast cancer patients with overexpression or amplification of HER2 gene. This phenomenon is probably related to genetic characteristics of both the tumor and the patient, and a type of treatment. Currently, a standard component of systemic therapy of HER2-positive breast cancer is trastuzumab, a monoclonal antibody against extracellular domain of HER2 receptor. Control of extracranial disease with trastuzumab increases the risk of brain metastases, which frequently occur during systemic stabilization or regression of other lesions. However, due to its high molecular weight and physico-chemical properties, trastuzumab does not cross through the blood-brain barrier and is ineffective in preventing and treating brain lesions. Another anti-HER agent used in breast cancer is lapatinib, a small-molecule tyrosine kinase inhibitor. Lapatinib has slightly higher ability to cross the blood-brain barrier, however activity in established brain metastases is modest. Experimental and clinical observations suggest, however, the role of lapatinib in prevention of brain metastases. In summary, the current progress in therapy of brain metastasis in HER2-positive breast cancer patients is fairly small and this problem remains a therapeutic challenge.

Onkol. Prak. Klin. 2010; 6, 5: 272–277

Get Citation

Keywords

breast cancer; monoclonal antibody; trastuzumab; tyrosine kinase inhibitor; lapatinib; epidermal growth factor receptor type 2; HER2

About this article
Title

Central nervous system metastases during anti-HER2 therapy in breast cancer patients

Journal

Oncology in Clinical Practice

Issue

Vol 6, No 5 (2010)

Article type

Review paper

Pages

272-277

Published online

2011-01-19

Bibliographic record

Onkol. Prak. Klin 2010;6(5):272-277.

Keywords

breast cancer
monoclonal antibody
trastuzumab
tyrosine kinase inhibitor
lapatinib
epidermal growth factor receptor type 2
HER2

Authors

Renata Duchnowska

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