Breast cancer brain metastases: the last frontier

Breast cancer represents the second most frequent cause of brain metastases after lung cancer, with metastases occurring in 10–16 % of patients

José Pablo Leone

2015

Scholarcy highlights

  • Breast cancer represents the second most frequent cause of brain metastases after lung cancer, with metastases occurring in 10–16 % of patients
  • The incidence of brain metastases seem to have increased in recent years, this is likely due to prolonged survival of patients receiving more efficient treatments and the availability of better imaging techniques that lead to increased detection of brain metastases
  • The development of brain metastases is a complex process, requiring invasion of the primary breast cancer cells into surrounding tissue and vessels, traffic through the circulatory system and colonization and growth in the brain parenchyma. This process takes a median of 32 months from the initial cancer diagnosis ; which shows that the breast cancer tumor cells, unlike other cancer cells, need more time to develop
  • The efficacy of lapatinib to prevent brain metastases was further tested in the CEREBEL trial, where patients with human epidermal growth factor receptor 2-positive metastatic breast cancer without central nervous system metastases were randomized to lapatinib or trastuzumab in combination with capecitabine
  • Patients with brain metastases were excluded from clinical trials evaluating systemic therapies and we are left with the unanswered question of how efficacious those therapies would be for patients with brain metastases
  • The large number of ongoing breast cancer-specific brain metastases trials is a step in the right direction

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