Opinion

Video

Case Study of a 54-Year-Old Woman With HER2+ Metastatic Breast Cancer and Brain Metastases: Optimal Treatment Approaches

Vijayakrishna Gadi, MD, PhD, presents the case of a 54-year-old woman with HER2-positive metastatic breast cancer exhibiting bone, liver, and brain lesions, and key opinion leaders share their perspectives on the most appropriate treatment approaches tailored to the patient's specific disease characteristics and metastatic sites.

Video content above is prompted by the following questions:

  • Patient Case: A 54-year-old woman with HER2+ metastatic breast cancer and brain metastases
    • Please describe your initial impressions of this case. How might you have treated this patient in your practice?
  • Per the NCCN guidelines, what is the preferred treatment approach for this patient/patients with systemic and CNS progression?
  • In which lines of therapy do the NCCN guidelines recommend using the tucatinib + trastuzumab + capecitabine regimen for patients with brain metastases?
  • Please discuss the differences between active and stable brain metastases and how these factors influence your treatment decisions.
    • At what points during metastatic breast cancer treatment do you typically screen for brain metastases?
    • How do you view the role of systemic therapy versus local therapy in the management of brain metastases in HER2-positive mBC?
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Sagar D. Sardesai, MBBS
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Albert Grinshpun, MD, MSc, head, Breast Oncology Service, Shaare Zedek Medical Center
Erica L. Mayer, MD, MPH, director, clinical research, Dana-Farber Cancer Institute; associate professor, medicine, Harvard Medical School