Brain metastases in HER2-positive breast cancer: The evolving role of lapatinib

Tomasello, Gianluca; Bedard, Philippe L.; de Azambuja, Evandro; Lossignol, Dominique; Devriendt, Daniel; Piccart-Gebhart, Martine J.

doi:10.1016/j.critrevonc.2009.11.003

« Previous Next »Critical Reviews in Oncology / Hematology
Volume 75, Issue 2 , Pages 110-121, August 2010

Brain metastases in HER2-positive breast cancer: The evolving role of lapatinib

Gianluca Tomasello
- Institut Jules Bordet, Université Libre de Bruxelles, 121 Boulevard de Waterloo, 1000, Brussels, Belgium
- Struttura Complessa di Oncologia, Azienda Istituti Ospitalieri di Cremona, Cremona, Italy
- Corresponding author at: Struttura Complessa di Oncologia, Azienda Istituti Ospitalieri di Cremona, Viale Concordia 1, 26100 Cremona, Italy. Tel.: +39 0372 405248; fax: +39 0372 405702.
Philippe L. Bedard
- Institut Jules Bordet, Université Libre de Bruxelles, 121 Boulevard de Waterloo, 1000, Brussels, Belgium
- Address: Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), 121 Boulevard de Waterloo, 1000, Brussels, Belgium. Tel.: +32 2 541 72 76; fax: +32 2 538 08 58.
Evandro de Azambuja
- Institut Jules Bordet, Université Libre de Bruxelles, 121 Boulevard de Waterloo, 1000, Brussels, Belgium
- Address: Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), 121 Boulevard de Waterloo, 1000, Brussels, Belgium. Tel.: +32 2 541 72 44; fax: +32 2 541 34 77.
Dominique Lossignol
- Institut Jules Bordet, Université Libre de Bruxelles, 121 Boulevard de Waterloo, 1000, Brussels, Belgium
- Tel.: +32 2 541 32 06; fax: +32 2 538 08 58.
Daniel Devriendt
- Institut Jules Bordet, Université Libre de Bruxelles, 121 Boulevard de Waterloo, 1000, Brussels, Belgium
- Address: Department of Radiation Therapy, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), 121 Boulevard de Waterloo, 1000, Brussels, Belgium. Tel.: +32 2 541 38 00; fax: +32 2 538 75 42.
Martine J. Piccart-Gebhart
- Institut Jules Bordet, Université Libre de Bruxelles, 121 Boulevard de Waterloo, 1000, Brussels, Belgium
- Address: Medical Oncology Clinic, Institut Jules Bordet, Université Libre de Bruxelles (U.L.B.), 121 Boulevard de Waterloo, 1000, Brussels, Belgium. Tel.: +32 2 541 32 06; fax: +32 2 538 08 58.

Accepted 13 November 2009. published online 10 December 2009.

Abstract

Due to improvements in diagnosis and systemic therapy, brain metastases are an increasingly common cause of morbidity and mortality for patients with advanced breast cancer. The incidence of symptomatic brain metastases among women with metastatic breast cancer ranges from 10% to 16%. The HER2 receptor, which is overexpressed in approximately 25% of all breast cancers, is an important risk factor for the development of central nervous system metastases. Surgery and radiation therapy are the primary approaches to the treatment of brain metastases but new chemotherapy and biological agents promise to play an important role in the future management of central nervous system disease. This article reviews the epidemiology, current treatment options and recent advances in the field, with a focus on HER2-positive disease and the emerging role of lapatinib for the treatment and prevention of brain metastases.

Keywords: Brain metastases, Breast cancer, HER2-positive, Trastuzumab, Lapatinib