AANS Neurosurgeon | Volume 26, Number 1, 2017

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Brain Metastasis Persists Despite Improved Targeted Treatment for HER2 Breast Cancer

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While new targets treatments developed across the past two decades have led to dramatic survival improvements for women with HER2-positive metastatic breast cancer, University of North Carolina Lineberger Comprehensive Cancer Center researchers and collaborators report that rates of breast cancer brain metastasis for women with this disease have not substantially declined. “We need better therapies to prevent brain metastasis,” said the study’s senior author Carey Anders, MD, a UNC Lineberger member, an associate professor in the UNC School of Medicine, and co-founder of a UNC Brain Metastases Specialty Clinic. “Treatments that have been developed have led to a remarkable improvement in survival for metastatic HER2-positive breast cancer, but are not preventing the development of brain metastasis even within two years of diagnosis.” The study examined the incidence of brain metastasis after diagnosis for three groups of patients. The researchers investigated the brain metastasis incidence in the period after a series of drugs were approved to treat HER2-positive metastatic breast cancer, starting with trastuzumab, also known as Herceptin, in the U.S. in 1998. Studies have shown that trastuzumab combined with postoperative chemotherapy has increased overall survival for HER2-positive breast cancers by 37 percent. It works by targeting a protein on the surface of a breast cancer cell, human epidermal growth factor 2 (HER2), that promotes cancer cell growth. 

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