Brain Benefits: Targeted Therapy Offers New Weapon Against HER2+ Breast Cancer with LM

This study (NCT03501979) investigated the drug combination of tucatinib (Tukysa), trastuzumab (Herceptin), and capecitabine for HER2-positive breast cancer with leptomeningeal metastases (LM). Treatment options for LM are limited, and survival rates are low.

The researchers enrolled 17 patients with HER2-positive breast cancer and newly diagnosed LM. All patients received the drug combination in cycles. The median overall survival was 10 months, which is longer than typically seen with LM. Out of 13 patients eligible for response evaluation, almost 40% achieved an objective response. All 13 patients experienced some level of clinical benefit, including stable disease or improvement in symptoms. Patients with neurological deficits showed improvement in over half of the cases. Quality of life and symptom burden also improved significantly.

This is the first study to show clear benefits of a systemic drug regimen for LM in HER2-positive breast cancer. These findings suggest that such treatments might be a good initial approach for managing LM, potentially improving patient outcomes.

Here, Mina Lobbous, MD, MPH, is an oncologist in the Brain Tumor and Neuro-Oncology Center at Cleveland Clinic, discusses this patient population and findings from the study presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting.