[Systemic Treatment of Brain Metastases From Breast Cancer: Cytotoxic Chemotherapy and Targeted Therapies]

Bull Cancer. 2013 Jan 1;100(1):7-14. doi: 10.1684/bdc.2012.1676.
[Article in French]

Abstract

Prevalence of brain metastases is increasing in breast cancer. Brain metastases represent a poor-prognosis disease for which local treatments continue to play a major role. In spite of the presence of a physiological blood-brain barrier limiting their activity, some systemic treatments may display a significant antitumor activity at the central nervous system level. In HER2-positive metastatic breast cancer with brain metastases not previously treated with whole brain radiotherapy, capecitabine and lapatinib combination obtains a volumetric reponse in two thirds of patients (LANDSCAPE study). If confirmed, these results could modify in selected patients the layout of therapeutic strategies. Promoting novel targeted approaches and innovative therapeutic combinations is a critical need to improve survival of breast cancer patients with brain metastases.

Keywords: brain metastases; breast cancer; capecitabine; lapatinib; systemic treatments.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Blood-Brain Barrier / physiology
  • Brain Neoplasms / blood supply
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / secondary*
  • Breast Neoplasms* / chemistry
  • Capecitabine
  • Deoxycytidine / analogs & derivatives
  • Deoxycytidine / therapeutic use
  • Female
  • Fluorouracil / analogs & derivatives
  • Fluorouracil / therapeutic use
  • Humans
  • Lapatinib
  • Molecular Targeted Therapy / methods*
  • Quinazolines / therapeutic use
  • Receptor, ErbB-2 / antagonists & inhibitors
  • Trastuzumab

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Quinazolines
  • Lapatinib
  • Deoxycytidine
  • Capecitabine
  • Receptor, ErbB-2
  • Trastuzumab
  • Fluorouracil