Fast Five Quiz: HER2+ Metastatic Breast Cancer Management

Winston Tan, MD


January 10, 2022

According to ASCO recommendations on disease management for patients with HER2+ metastatic breast cancer with brain metastases, patients should receive appropriate local therapy and systemic therapy, if indicated.

Local therapies include surgery, whole-brain radiotherapy, and stereotactic radiosurgery. Treatment options will depend on patient prognosis, presence of symptoms, resectability, number and size of metastases, prior therapy, and whether metastases are diffuse.

Systemic therapy options include HER2-targeted antibody therapy plus chemotherapy (eg, trastuzumab, pertuzumab, and taxane or tucatinib + trastuzumab + capecitabine). Systemic options depend upon disease severity and number of treatment failures and/or disease progression.

Other possibilities for these patients, depending on the above factors, are best supportive care, enrollment in a clinical trial, and/or palliative care.

Due to the high incidence of brain metastases among patients with HER2+ advanced breast cancer, clinicians should not perform routine MRI but should opt instead for a low threshold for MRI of the brain.

Learn more about the treatment options for patients with HER2+ advanced breast cancer.

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