: Brain metastases (BMs) are prevalent among patients diagnosed with human epidermal growth factor receptor 2 (HER2)positive metastatic breast cancer (BC), with the incidence rate exceeding 30%. The management of BMs typically involves multiple approaches, such as surgery, radiation therapy (RT), systemic treatments, and end-of life care. Standard brain RT includes stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) for limited disease and whole brain radiotherapy (WBRT) for extensive disease. Recent advancements in RT and systemic treatments may change the paradigm for patients who experience prolonged survival despite BMs, especially in HER2-positive, hormone receptor (HR) positive BC patients. In recent studies, SRT for multiple BM sites (more than 4) has shown similar efficacy compared to irradiation of a limited number of lesions (1 to 3) while not increasing toxicity. This systematic review summarizes the available literature data regarding the RT approach to BMs in HER2-positive BC patients and highlights the need to optimize treatment combinations with specific emphasis on RT.
Brain metastases for Her2 positive breast cancer patients: a systematic review (on the behalf of Italian Association of Radiotherapy and Clinical Oncology)
Fiorentino, Alba;
2025-01-01
Abstract
: Brain metastases (BMs) are prevalent among patients diagnosed with human epidermal growth factor receptor 2 (HER2)positive metastatic breast cancer (BC), with the incidence rate exceeding 30%. The management of BMs typically involves multiple approaches, such as surgery, radiation therapy (RT), systemic treatments, and end-of life care. Standard brain RT includes stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) for limited disease and whole brain radiotherapy (WBRT) for extensive disease. Recent advancements in RT and systemic treatments may change the paradigm for patients who experience prolonged survival despite BMs, especially in HER2-positive, hormone receptor (HR) positive BC patients. In recent studies, SRT for multiple BM sites (more than 4) has shown similar efficacy compared to irradiation of a limited number of lesions (1 to 3) while not increasing toxicity. This systematic review summarizes the available literature data regarding the RT approach to BMs in HER2-positive BC patients and highlights the need to optimize treatment combinations with specific emphasis on RT.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
